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[Therapeutic facial surgery possibilities for orbital tumors]
1Universitätsklinik für Mund-, Kiefer- und Gesichtschirurgie, Plastische Operationen, Kliniken Essen Mitte, Deutschland.
Abstract:
Based on a large experience of more than 400 orbital tumours which were treated operatively, the surgical strategies are described in detail. A surgical approach including the temporary removal of one or more bony orbital walls provided excellent exposure of the intraorbital structures. Using microsurgical techniques for tumour removal the surgical morbidity could be minimized. Subsequent refixation of the osteotomized orbital bones with microplates and screws and skin incisions within the hair bearing parts of the skull resulted in excellent postoperative function and cosmesis. For many malignant orbital tumours definitive cure can only be achieved by an orbital exenteration procedure. An individually tailored surgical and reconstructive strategy (if possible preservation of eyelid skin, tarsal and bulbar conjunctiva) gives a significant benefit, as well with respect to function as to the esthetic outcome of the patient.
Insights
Surgical strategies for orbital tumors, including temporary bone wall removal and microsurgery, minimize complications. Tailored approaches, including orbital exenteration for malignant cases, improve function and cosmetic outcomes.
Area of Science:
- Ophthalmology
- Neurosurgery
- Surgical Oncology
Context:
- Orbital tumors present complex surgical challenges requiring specialized approaches.
- A large experience with over 400 surgically treated orbital tumors informs these strategies.
Purpose:
- To detail effective surgical strategies for managing a wide range of orbital tumors.
- To optimize outcomes regarding function and cosmesis in orbital tumor surgery.
Summary:
- Surgical approaches involving temporary removal of orbital walls offer excellent exposure for microsurgical tumor removal, minimizing morbidity.
- Refixation of orbital bones with microplates and screws, combined with concealed incisions, ensures superior postoperative function and cosmesis.
- For malignant orbital tumors, orbital exenteration with tailored reconstruction, preserving key tissues where possible, is crucial for cure and aesthetic results.
Impact:
- Establishes best practices for orbital tumor surgery, enhancing patient function and aesthetic results.
- Provides a framework for managing both benign and malignant orbital neoplasms.
- Highlights the importance of individualized reconstructive strategies following orbital exenteration.