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Related Experiment Video

Updated: Jun 28, 2026

Three-Dimensional Reconstruction of Orbital Fractures
08:18

Three-Dimensional Reconstruction of Orbital Fractures

Published on: May 16, 2025

Orbital exenteration in elderly patients: personal experience.

A Croce1, A Moretti, L D'Agostino

  • 1Otorhinolarygology Unit, Department of Surgical Sciences, Clinical and Experimental, G. D'Annunzio University of Chieti and Pescara, Italy. acroce@unich.it

Acta Otorhinolaryngologica Italica : Organo Ufficiale Della Societa Italiana Di Otorinolaringologia E Chirurgia Cervico-Facciale
|October 23, 2008
PubMed
Summary

Orbital exenteration, a surgery for life-threatening cancers, is increasingly performed on elderly patients. Simple reconstruction methods like skin grafts or myocutaneous flaps offer good outcomes with reduced complications in this population.

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Area of Science:

  • Ophthalmology
  • Surgical Oncology
  • Geriatric Medicine

Background:

  • Orbital exenteration is a radical surgical procedure for advanced orbital, paranasal sinus, or periocular malignancies.
  • The incidence of exenterations is rising in elderly patients due to increased life expectancy and higher rates of skin cancers.

Observation:

  • This report details eight orbital exenterations in elderly patients (mean age 75) for malignancies (basal cell carcinoma, squamous cell carcinoma, fibrosarcoma, melanoma) and one case of rhinocerebral mucormycosis.
  • Surgical reconstruction involved full-thickness skin grafts (5 cases), pedicled myocutaneous flaps (2 cases), or a combined flap and skin graft (1 case).

Findings:

  • Post-operative survival varied by diagnosis: 3 of 4 basal cell carcinoma patients were disease-free at follow-up, as was the squamous cell carcinoma patient.

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  • Patients with melanoma, fibrosarcoma, and mucormycosis did not survive the follow-up period.
  • Reconstruction with full-thickness skin grafts or pedicled myocutaneous flaps yielded favorable outcomes comparable to complex reconstructions, with reduced morbidity and operative time.

    • Implications:

    • Full-thickness skin grafts and pedicled myocutaneous flaps are effective and simpler reconstruction options for elderly patients undergoing orbital exenteration, especially those with comorbidities.
    • These methods achieve satisfactory functional and aesthetic results while minimizing donor site morbidity and surgical duration.
    • The findings support the use of less complex reconstructive techniques in geriatric populations to improve surgical tolerance and outcomes.