Oncologic Surgery of the Eyelid and Orbital Region

Abstract

Oncologic surgery of the eyelid and orbital region is a challenge in dermatologic surgery. This region presents difficulties and possible complications that do not exist at other sites, including ectropion, epiphora, corneal exposure, keratitis, conjunctivitis, and lagophthalmos. Adequate oncologic surgery associated with the best possible functional and cosmetic result requires extensive knowledge of the anatomy, innervation, and blood supply of the eyelid and anatomy of the lacrimal apparatus. We present examples of reconstructive surgical techniques that can be used after the excision of tumors of the upper or lower eyelid, with descriptions of the different flaps and grafts employed in our department in recent years. We also review the surgical techniques according to the site and size of the lesions.

The Prevalence and Treatment Costs of Non-Melanoma Skin Cancer in Cluj-Napoca Maxillofacial Center

“…However, 19% of head and neck cancers are located on the skin [ 25 ]. Particularly, the orbital region had the highest cost of treatment per episode, which may be due to the difficulty of local reconstruction of this anatomical area [ 28 , 29 ]. These results are different from other research, where nasal and auricle NMSC had the highest treatment costs [ 5 , 16 , 19 ].…”

Radiotherapy in Periocular Cutaneous Malignancies: A Retrospective Study

“…Besides BCC, the most frequent malignant tumor, SCC, Merkel cell carcinoma, cutaneous melanoma, as well as in situ lesions and rare tumors can occur in this area, accounting for a total of 5–10% of all cutaneous malignancies [1-3]. Not only may periocular tumors behave more aggressively and show higher recurrence rates, but they also represent a challenge for treatment compared to cutaneous lesions at other sites [10, 12, 19]. Previous data show that periocular neoplasms most frequently occur on the lower eyelid and the medial canthus [1, 2, 20-22], which are surgically challenging areas, carrying a risk of functional and aesthetic complications [10, 12, 19].…”

“…Not only may periocular tumors behave more aggressively and show higher recurrence rates, but they also represent a challenge for treatment compared to cutaneous lesions at other sites [10, 12, 19]. Previous data show that periocular neoplasms most frequently occur on the lower eyelid and the medial canthus [1, 2, 20-22], which are surgically challenging areas, carrying a risk of functional and aesthetic complications [10, 12, 19]. Moreover, as observed in our cohort too, periocular tumors tend to develop in fair-skin patients over 60 years of age, who have a history of significant sun exposure [20, 22] – all factors which are known to be associated with the development of skin cancer at any site [23-25], hence concomitant skin cancer is not rare.…”

“…Likewise, in situ lesions, such as actinic keratosis (AK) and Bowen’s disease (BD), can affect the periocular skin [2, 3]. Although the majority of cutaneous neoplasms can be treated by excision [4-9], excessive surgical intervention in the periocular site may lead to anatomical dysfunction and poor aesthetic outcome [10-12]. Less invasive approaches, such as photodynamic therapy or cryotherapy, represent a treatment option for superficial cutaneous neoplasms [7-9].…”