Orbital exenteration is a devastating procedure that has a tremendous social and psychological impact upon the patient. The resulting defect can be very large and the reconstruction of an extended exenterated orbit may present a challenging problem, especially when the peri-orbital skin is atrophic or also damaged by the sun exposure. One-stage orbital reconstruction is highly desirable for patients who undergo extended exenterations because the early postoperative aesthetic result is quite important. In this article we describe our experience with a biplanar cervicofacial flap for one-stage reconstruction of complex orbit defects. The face is extremely vulnerable to sun-light damage and white people who are chronically exposed to ultraviolet radiation have a high rate of non melanoma skin cancers (NMSC) in the periocular region. Basal cell and squamous cell carcinomas are extremely frequent in patients with chronic sun-damage and in advanced cases the orbit may be invaded by malignancies originated from the eyelids. Orbital tumors are very close to the skull base and if not completely removed recur with an unfavorable prognostic. In most cases of orbital invasion by periocular NMSC extended exenterations are necessary to completely remove these malignancies.
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