Mustardé cheek rotation flap for lower eyelid and medial canthal reconstruction following basal cell carcinoma excision: A prospective study
Niraj Kumar Yadav, Shachi Srivastava, Bhupender SinghPurpose:
The purpose of this study was to evaluate the oncologic, functional, and esthetic outcomes of Mustardé cheek rotation flap reconstruction following excision of basal cell carcinoma (BCC) involving the lower eyelid and medial canthus.
Design:
Prospective, interventional, single-center clinical study.
Materials and Methods:
Fifty-two patients with histopathologically confirmed lower eyelid or medial canthal BCC underwent wide local excision with a 4 mm clinical margin at a tertiary care center in northern India between December 2023 and December 2024. All defects were reconstructed using Mustardé’s cheek rotation flap. Patients were evaluated postoperatively at 1 week, 1 month, 3 months, 6 months, and subsequent follow-up visits, with a mean follow-up duration of 11.2 ± 1.8 months. Oncologic safety, functional recovery, postoperative complications, and esthetic outcomes were assessed using the Visual Analog Scale (VAS) and Patient and Observer Scar Assessment Scale (POSAS).
Results:
The mean age of the study cohort was 64.2 ± 9.8 years. The cohort included 30 males and 22 females, corresponding to a male-to-female ratio of 15:11, or approximately 1.36:1, with males comprising 57.7% and females 42.3% of the study population. Histopathologically tumor-free margins were achieved in all cases, with no clinical recurrence observed during follow-up. Mean wound healing time was 18.5 ± 4.2 days. Postoperative complications included distal flap necrosis (3.8%), mild ectropion (1.9%), and wound infection (1.9%), all managed conservatively. Mean VAS scores improved progressively, reaching 9.1 ± 0.7 at final follow-up. Observer and patient POSAS scores improved to 12.4 ± 3.2 and 13.1 ± 2.9, respectively.
Conclusion:
Mustardé cheek rotation flap provides a reliable single-stage reconstructive option for periocular BCC, with favorable short-term oncologic control, satisfactory functional recovery, and acceptable cosmetic outcomes.