Ophthalmic Changes Following Maxillectomy With or Without Postoperative Radiation Therapy

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.