Orbital exenteration in periorbital malignancies

Roche, Phoebe; Timon, Conrad

doi:10.1016/j.surge.2011.03.006

Cited by 21 publications

(18 citation statements)

References 10 publications

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“…4,12,13 Although clinical signs including a palpable mass with bony fixation, impaired ocular motility, and globe displacement are all highly suggestive of orbital involvement, more than one third of patients with orbital invasion are initially asymptomatic. 5,14 Orbital exenteration refers to complete excision of periorbital tissues, orbital contents, and orbital fat, extraocular muscles, bulbar conjunctiva, and sclera. 1,15 It is indicated for tumors of the orbit, periorbita, conjunctiva, globe, and paranasal sinuses that have invaded the orbital apex, retrobulbar fat, extraocular muscles, bulbar conjunctiva, or sclera and which are potentially fatal, progressive, and cannot be effectively treated by other modalities.…”

Section: Introductionmentioning

confidence: 99%

Orbital exenteration for advanced periorbital non-melanoma skin cancer: prognostic factors and survival

Gerring

Ott

Curry

et al. 2016

Eye

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Purpose To describe prognostic factors and survival outcomes in patients who underwent orbital exenteration for periocular nonmelanoma cutaneous malignancies. Methods The authors performed an institutional review board-approved retrospective review of all patients who underwent orbital exenteration for nonmelanoma periocular cutaneous malignancies at a tertiary care hospital system over a 10-year period. Patient demographics, tumor, and treatment data were recorded. Survival outcomes included disease-free survival (DFS) and overall survival (OS). Log-rank tests were used to test for difference in survival curves among various potential prognostic indicators, and multivariate analysis was performed using Cox's proportional hazards model. Results Forty-nine patients with an average age of 70.3 years were followed with a median follow-up of 17.5 months. At 2 years the OS was 78% while the DFS was 61%. The mean DFS for basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and sebaceous gland carcinoma (SGC) were 52.6, 39.2 and 28.1 months, respectively. Multivariate analysis demonstrated that only positive final surgical margin was predictive of worse outcome (P = 0.002). Recurrences were most frequent in the first 2 years. Conclusions Despite the relatively more aggressive nature of periocular malignancies that have invaded the orbit, orbital exenteration offers an overall 2-year DFS of 60%. BCC had the greatest mean survival time, however this was not statistically significant. We found worse prognosis with positive final surgical margins and recommend a multidisciplinary surgical approach to achieve complete resection when indicated.

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Section: Introductionmentioning

confidence: 99%

Orbital exenteration for advanced periorbital non-melanoma skin cancer: prognostic factors and survival

Gerring

Ott

Curry

et al. 2016

Eye

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“…This was a difficult case to solve and it was only possible to do so with a multidisciplinary approach17 18 and special care to the patient expectations.…”

Section: Discussionmentioning

confidence: 99%

Surgical resection of invasive adenoid cystic carcinoma of the lacrimal gland and wound closure using a vertical rectus abdominis myocutaneous free flap

Andrade¹,

Figueiredo

Matias³

et al. 2016

BMJ Case Reports

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A 64-year-old man presented with a 3-month history of recurrent conjunctivitis. He was evaluated by an ophthalmologist and submitted to a CT scan that revealed an intraconic mass with invasion of the lateral orbital wall. He was operated, the mass was completely removed (with preservation of the intraorbital structures) and the lateral orbital wall rebuilt. The histopathological analysis revealed an adenoid cystic carcinoma of the lacrimal gland. 4 months later a painful recurrence of the lesion was diagnosed with invasion of the orbital roof and eyelids. After a multidisciplinary discussion and request from the patient, an exenteration of the orbit and removal of the lateral and superior orbital wall and dura mater was performed with the objective of a total resection. The wound and orbit were closed with a vertical rectus abdominis myocutaneous free flap to ensure closure.

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“…Therefore, frozen section examination should be performed during the operation. The tumor histology is important, as exenteration of the orbit is less often necessary in cases of esthesioneuroblastoma, adenocystic low-grade carcinoma and benign tumors, adenocarcinoma, and squamous cell carcinoma [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the Orbit With a Temporalis Muscle Flap After Orbital Exenteration

Uyar

Kumral

Yıldırım

et al. 2015

Clin Exp Otorhinolaryngol

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ObjectivesThis study presents the role of the temporalis muscle flap in primary reconstruction after orbital exenteration.MethodsA retrospective nonrandomized study of orbital exenterations performed between 1990 and 2010 for malignant tumors of the skin, paranasal sinus, and nasal cavity is presented.ResultsThe study included 13 patients (nine men, four women; age range, 30-82 years) with paranasal sinus, nasal cavity, or skin carcinomas. Primary reconstruction of the cavity was performed in all patients after orbital exenteration. No visible defects in the muscle flap donor site were present. Local recurrences were readily followed up with nasal endoscopy, whereas radiology helped to diagnose intracranial involvement in three patients. Two patients died of systemic metastases and five died for other reasonsConclusionThe temporalis muscle flap is readily used to close the defect after orbital exenteration, and does not prevent the detection of recurrence.

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Orbital exenteration in periorbital malignancies

Cited by 21 publications

References 10 publications

Orbital exenteration for advanced periorbital non-melanoma skin cancer: prognostic factors and survival

Orbital exenteration for advanced periorbital non-melanoma skin cancer: prognostic factors and survival

Surgical resection of invasive adenoid cystic carcinoma of the lacrimal gland and wound closure using a vertical rectus abdominis myocutaneous free flap

Reconstruction of the Orbit With a Temporalis Muscle Flap After Orbital Exenteration

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