Reconstructive options following orbital exenteration

Abstract

Purpose of review. The purpose of this review is to examine current trends in reconstruction following orbital exenteration. Defects ranging from isolated exenteration to more complex midface resections are explored.Recent findings. Goals of reconstruction include separating the sino-orbital cavities and creating a safe, stable wound that can withstand adjuvant radiation. When planning for orbital rehabilitation, it is important to create a concave cavity that can accommodate a prosthesis. This is primarily achieved through secondary granulation or split-thickness skin grafts. Recently, the use of dermal allografts has been investigated and shown good success with epithelization of the orbital cavity. For complex orbitomaxillectomy defects, musculocutaneous free tissue flaps remain the mainstay for reconstruction. Summary.Reconstructive options following orbital exenteration are based on extent of the defect, need for postoperative radiation, and plans for orbital rehabilitation with prosthesis.

Skin and Bone: Intact Fish Skin to Reconstruct Traumatic Orbital Floor and Wall Defects

“…10 The type of tissue selected for orbital repair depends on the patient factors, the extent of the defect, plans for adjuvant radiation, malignancy recurrence monitoring, etc. 2,3 Alongside split-thickness skin grafts, meshed acellular human dermal allografts, and musculocutaneous free tissue flaps, Kerecis should be considered a viable option for orbital reconstruction.…”

“…1 In cases of orbital tissue resection in malignancy, the remaining tissue must withstand potential adjuvant radiation and allow for monitoring for recurrence of malignancy. 2,3 Large bony defects can be repaired with skin grafts, bone grafts, fascial slings, muscle flaps, synthetic materials, cartilage, and acellular cadaveric dermal matrix allograft. 1 Of synthetic materials, nonmesh and inert materials can minimize excess orbital fibrosis that can cause orbital adherence syndrome.…”

Surgical treatment of orbital tumors in a single center: Analysis and results

“…[3,15] The reconstruction of the orbital e orbital prosthesis can improve the patient's appearance, enable early rehabilitation, shorten surgery and hospitalization time, lower treatment costs, and allow early psychosocial reintegration. [55] e reconstruction of the orbital area, particularly following procedures like orbital exenteration, is a critical aspect of both physical and psychological rehabilitation for patients. is process often involves the use of biocompatible materials such as titanium mesh or methyl methacrylate.…”