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Three-Dimensional Reconstruction of Orbital Fractures

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Orbital hyperostosis following exenteration.

James Chris Fleming¹, James S Linder, Zeynel A Karcioglu

¹Hamilton Eye Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee 38103, USA.

Ophthalmic Plastic and Reconstructive Surgery

|September 23, 2008

Summary

Orbital exenteration can lead to diffuse hyperostosis of orbital bones due to chronic osteitis from delayed granulation tissue healing. This finding is crucial for understanding post-surgical changes in orbital malignancies.

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Area of Science:

Ophthalmology
Oncology
Radiology

Background:

Orbital exenteration is a radical surgical procedure for advanced periorbital and orbital malignancies.
Understanding the sequelae of orbital exenteration is essential for patient management and follow-up.

Observation:

Three patients who underwent orbital exenteration for advanced malignancies presented with unilateral, diffuse hyperostosis of orbital bones.
Clinical, radiologic (CT), and histopathologic features were reviewed.

Findings:

Computed tomography (CT) revealed thickened orbital walls in all three postexenteration patients.
Histopathology demonstrated necrotic bone trabeculae, chronic inflammation, fibrosis, and inflamed granulation tissue.

Implications:

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Delayed healing of granulation tissue during secondary intention may cause chronic osteitis.
This chronic osteitis is a likely cause of the observed postoperative diffuse hyperostosis of orbital bones.
These findings highlight a potential long-term complication following orbital exenteration for malignancy.