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Orbital exenterations: an 18-year experience from a single head and neck unit
Chih-Hung Kuo1, Kan Gao, Anthony Clifford
1Central Clinical School, Sydney Medical School, Australia. chkuo@med.usyd.edu.au
ANZ Journal of Surgery
|April 27, 2011
Summary
Orbital exenteration for malignancy offers high survival and locoregional control rates in selected patients. Early post-operative monitoring is crucial for detecting recurrence after this aggressive surgical approach.
Area of Science:
- Ophthalmology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Orbital exenteration is a radical surgical procedure for advanced orbital malignancies.
- Understanding outcomes is vital for patient selection and management.
Purpose of the Study:
- To review the outcomes of patients undergoing orbital exenteration for malignancy.
- To evaluate survival rates, local control, and complications.
Main Methods:
- Retrospective review of 38 patients who underwent orbital exenteration between 1990 and 2008.
- Analysis of patient demographics, malignancy types, surgical procedures, and post-operative outcomes.
Main Results:
- Squamous cell carcinoma, basal cell carcinoma, and melanoma were the most common malignancies.
- High rates of disease-specific survival (97% at 1 year, 92% at 5 years) and local control (83% at 1 year, 55% at 5 years) were observed.
- Cerebrospinal fluid leak and wound complications were the main post-operative issues.
Conclusions:
- Orbital exenteration is a viable option for well-selected patients with orbital malignancy, achieving high survival and locoregional control.
- Free flap reconstruction is a reliable technique for managing defects post-exenteration.
- The first post-operative year is critical for monitoring disease recurrence.
