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Ophthalmic Changes Following Maxillectomy With or Without Postoperative Radiation Therapy.

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|July 14, 2019
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Maxillectomy for midface cancer can cause eye complications like eyelid retraction and dry eye. Adjuvant radiotherapy may increase these risks, with lower eyelid malposition being a significant change.

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Area of Science:

  • Ophthalmology
  • Head and Neck Surgery
  • Oncology

Background:

  • Maxillectomy is a surgical procedure for midface malignancies.
  • Ophthalmic complications can significantly impact patient quality of life post-surgery.

Purpose of the Study:

  • To evaluate ophthalmic complications after maxillectomy.
  • To quantitatively assess anatomical changes, particularly eyelid position, following maxillectomy with or without adjuvant radiotherapy.

Main Methods:

  • Retrospective review of 24 patients undergoing maxillectomy for sinus and/or paranasal cancer.
  • Ophthalmic examinations to identify postoperative sequelae.
  • Quantitative analysis of eyelid position using computer software on preoperative and postoperative photos.

Main Results:

  • Common complications included retraction/ectropion (50%), epiphora (29%), and exposure keratopathy (25%).
  • Adjuvant radiotherapy was associated with a higher incidence of ophthalmic complications.
  • Significant quantitative changes observed in margin reflex distance (MRD2) and inferior scleral show post-surgery.

Conclusions:

  • Maxillectomy poses a significant risk for periocular complications.
  • Lower eyelid malposition is a key quantitative change, potentially worsened by radiotherapy and inferior orbital rim removal.