Classification of orbital exenteration and reconstruction

Kesting, Marco; Koerdt, Steffen; Rommel, Niklas; Mücke, Thomas; Wolff, Klaus‐Dietrich; Nobis, Christopher-Philipp; Ringel, Florian; Frohwitter, Gesche

doi:10.1016/j.jcms.2017.01.003

Cited by 50 publications

(73 citation statements)

References 16 publications

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“…Often the resection can involve other surrounding structures such as the nose, paranasal sinuses, or maxilla. [1][2][3] A common classification separates the defect into types I, II, III, and IV, with type I defined a simple exenteration. Type IIa defines an extended orbital exenteration with loss of a single orbital wall or rim, while type IIb involves the loss of several orbital walls.…”

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confidence: 99%

“…Types III and IV involve additional defects as a result of the resection. 3 Various strategies have been employed for orbital reconstruction and rehabilitation. Healing by secondary intention has been described as one option.…”

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confidence: 99%

“…Various reconstructive techniques have been employed ranging from split thickness skin grafts (STSGs), to regional flaps, and to free tissue reconstruction. 3,[5][6][7][8][9][10][11] Free tissue transfer is reserved primarily for advanced orbital exenteration defects, usually types III and IV. Here we review several regional reconstructive options utilized primarily for type I and II orbital exenteration defects.…”

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confidence: 99%

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Regional Reconstruction of Orbital Exenteration Defects

Jategaonkar

Vernon

Byrne

2019

Seminars in Plastic Surgery

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Aggressive disease such as invasive fungal infections or malignancies may necessitate orbital exenteration. The defects of orbital exenteration are often complex involving adjacent structures. Rehabilitation of the orbital exenteration defect poses unique challenges to the reconstructive surgeon. Various options have been described ranging from secondary intention to microvascular free tissue reconstruction. Here the authors review local/regional options for reconstruction of orbital exenteration defects.

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confidence: 99%

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Regional Reconstruction of Orbital Exenteration Defects

Jategaonkar

Vernon

Byrne

2019

Seminars in Plastic Surgery

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“…1 One must distinguish between enucleation, which involves globe resection only, and exenteration, in which the entire orbit including the globe, the eyelids, the retrobulbar soft tissues, and periosteum are potentially removed. 1 Indications for OE include primary or recurrent tumors involving the orbital apex, invasion through periorbita, involvement of retrobulbar fat, extension into the extraocular muscles, and invasion of the conjunctiva or sclera. Additionally, OE can be palliative in situations where there are severe local symptoms or a diminished quality of life.…”

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confidence: 99%

“…8 In one study, indications for OE included primary tumors of the eye (35.71%), tumors of oral cavity or maxillary sinus (35.71%), skin (23.81%), and brain (4.77%). 1 According to another source, the paranasal sinuses and/or nasal cavity are the sites of origin of the majority of tumors requiring exenteration. 9 Mucormycosis is well known as an opportunistic fungal infection that may require OE.…”

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confidence: 99%

Considerations in Orbital Exenteration

Sokoya

Cohn

Kohlert

et al. 2019

Seminars in Plastic Surgery

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Orbital exenteration (OE) is a radical operation associated with significant psychosocial disability and functional impairment. Indications for OE include primary tumors of the eye, oral cavity, paranasal sinuses, skin, and brain. Careful consideration regarding the likelihood of local control and cure is needed before proceeding with this operation. Multidisciplinary work-up should be performed before proceeding with surgery. The method of reconstruction after OE should be tailored to the defect and the postoperative needs of the patient. Appropriate follow-up and rehabilitation should be arranged for the patient.

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Simple, but effective: Nasal splinting for airway securement in free flap reconstruction following orbital exenteration

et al. 2021

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Orbital exenteration is a disfiguring procedure that often results in free tissue transfer for reconstructive purposes. The reconstructive focus is the obliteration of dead space while sparing the nasal airway, particularly if the medial orbital wall was resected. Prolapse of transferred tissue into the nasal airway may cause breathing difficulties drastically compromising quality of life. The objective of this study was to demonstrate the effectiveness and feasibility of temporary nasal septum splints as mechanical support for transferred tissue, to prevent airway obstruction. This novel application technique was employed in three patients between 2017 and 2018. No flap loss or sino‐orbital fistulas were observed. On postoperative MRI and endoscopy, a patent nasal airway was observed at all times. Temporary nasal splinting in combination with free tissue transfer proved to be a simple, but effective reconstructive option for securing the nasal airway following orbital exenteration with resection of the medial orbital wall.

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Classification of orbital exenteration and reconstruction

Cited by 50 publications

References 16 publications

Regional Reconstruction of Orbital Exenteration Defects

Regional Reconstruction of Orbital Exenteration Defects

Considerations in Orbital Exenteration

Simple, but effective: Nasal splinting for airway securement in free flap reconstruction following orbital exenteration

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