Évaluation des techniques de reconstruction après exentération orbitaire. À propos de 56 cas

Langlois, B; Jacomet, P.V.; Putterman, Marc; Morax, S; Galatoire, O.

doi:10.1016/j.jfo.2011.10.014

Cited by 15 publications

(5 citation statements)

References 22 publications

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“…Orbital exenteration is a radical and disfiguring surgical procedure mainly performed in case of orbital cancers. BCC is the most common tumour reported in the current literature [ 1 , 6 , 12 – 14 ]. In our study, however, conjunctival melanoma was the most prevalent tumour ( n = 14/25, 56%).…”

Section: Discussionmentioning

confidence: 99%

Orbital exenteration and conjunctival melanoma: a 14-year study at the Jules Gonin Eye Hospital

Martel

Oberic

Moulin

et al. 2020

Eye

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Purpose To report our 14-year experience with orbital exenteration and assess risk factors for poor prognosis by focusing on conjunctival melanoma. Patients and method A retrospective study was conducted in our tertiary care centre (Jules Gonin Eye Hospital, Lausanne, Switzerland) between 2003 and 2017. Inclusion criteria were patients aged ≥18 years with a follow-up >12 months, without metastatic spread at the time of surgery. Data recorded were age, gender, tumour histology, surgical technique, postoperative complications, surgical margin status, local recurrence, postoperative radiation beam therapy and metastatic status. Results Twenty-five patients with a mean age of 63.2 years (38–92) were included. Conjunctival melanoma was the most frequently identified tumour ( n = 14, 56%) followed by conjunctival squamous cell carcinoma ( n = 4, 16%), sebaceous carcinoma ( n = 3, 12%), choroidal melanoma ( n = 2, 8%) and basal cell carcinoma ( n = 2, 8%). Eighteen tumours (72%) originated from the conjunctival tissue. Clear surgical margins were achieved in 21 (84%) patients. Fourteen (56%) patients experienced distant metastases and died from metastatic spread after a mean follow-up of 52.3 months (6–120). The 1-, 3- and 5-year overall survival (OS) was 96%, 72% and 60%, respectively. In the univariate analysis, positive surgical margins, local recurrence and metachronous metastases were associated with a decreased OS ( p = 0.002, p = 0.005 and p = 0.007, respectively). In the multivariate analysis, positive surgical margins and metachronous metastases were also associated with a decreased OS ( p = 0.02 and p = 0.042, respectively). Conjunctival melanoma was not associated with a poorer prognosis ( p = 0.280). Conclusion Free surgical margins are needed to increase OS. To achieve clearer surgical margins, neoadjuvant targeted therapies/immunotherapies may be considered.

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Section: Discussionmentioning

confidence: 99%

Orbital exenteration and conjunctival melanoma: a 14-year study at the Jules Gonin Eye Hospital

Martel

Oberic

Moulin

et al. 2020

Eye

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“…10 The type of tissue selected for orbital repair depends on the patient factors, the extent of the defect, plans for adjuvant radiation, malignancy recurrence monitoring, etc. 2,3 Alongside split-thickness skin grafts, meshed acellular human dermal allografts, and musculocutaneous free tissue flaps, Kerecis should be considered a viable option for orbital reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…1 In cases of orbital tissue resection in malignancy, the remaining tissue must withstand potential adjuvant radiation and allow for monitoring for recurrence of malignancy. 2,3 Large bony defects can be repaired with skin grafts, bone grafts, fascial slings, muscle flaps, synthetic materials, cartilage, and acellular cadaveric dermal matrix allograft. 1 Of synthetic materials, nonmesh and inert materials can minimize excess orbital fibrosis that can cause orbital adherence syndrome.…”

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confidence: 99%

Skin and Bone: Intact Fish Skin to Reconstruct Traumatic Orbital Floor and Wall Defects

Steinberger,

Vogt,

Tan

2024

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Orbital reconstruction following orbital trauma, tissue sacrifice from cancer resection, or other tissue loss poses a unique challenge for surgeons. Factors to consider include the patient’s systemic health status, potential for adjuvant radiation, final composition, and strength of the graft, infection risk, graft rejection, status of visual function, and cosmetic outcome. In settings where a permanent artificial implant is avoided due to exposure or infection risk, potential tissue utilized includes xenografts, allografts, and autografts—each with variable benefits and drawbacks, depending on the surgical goals of the repair. We describe a case of orbital reconstruction after a gunshot wound to the left orbit using tri-layer Kerecis (decellularized intact North-Atlantic cod fish skin) with excellent globe position and maintenance of ocular motility.

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“…2 However, injection of HA fillers increased by 58.4% between 2014 and 2018. 3 HA-related ischemia is thought to be due to the retrograde flow of the filler causing embolic phenomena at narrow points of arterial flow or a concurrent thrombotic process. Accidental introduction of filler into a peripheral vessel connected to the ophthalmic artery can occur from inadvertently puncturing a vessel wall or cannulating a distal branch.…”

Section: Discussionmentioning

confidence: 99%

“…There have been less than 10 cases of CEIS in the literature; most occurred in isolation, while 1 case occurred in association with cat eye syndrome, and another case had CEIS in addition to microphthalmia in OU, a total retinal detachment in the OD, and a cataract and persistent fetal vasculature in the OS. [1][2][3][4][5][6][7] Several of these cases have been associated with floppy eyelid syndrome (FES) raising the question of if FES and CEIS reside on a spectrum of disease. Herein, we describe a case of CEIS and FES complicated by infantileacquired eyelid eversion due to a prostaglandin E1 (PGE1) infusion in a neonate.…”

Section: Casementioning

confidence: 99%

Isolated Ophthalmoplegia After Periorbital Hyaluronic Acid Filler Injection

Bruce,

Esmaili

2024

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Facial filler injections are the second most commonly performed in-office cosmetic procedure. Vision loss is the most feared complication of hyaluronic acid (HA) filler injection, but isolated ophthalmoplegia can also occur. We report the case of a 45-year-old woman who developed nausea and diplopia following HA filler injection to the bilateral periorbital region. She presented with a left hypertropia and left-sided motility deficit without vision involvement. MRI of the orbits demonstrated mild enhancement and enlargement of the left inferior rectus and inferior oblique muscles. Treatment consisted of hyaluronidase injection and oral steroids. HA filler can cause isolated ocular misalignment and diplopia without associated vision loss. Patients should be counseled on these risks before undergoing soft tissue augmentation of the face with HA filler.

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Évaluation des techniques de reconstruction après exentération orbitaire. À propos de 56 cas

Cited by 15 publications

References 22 publications

Orbital exenteration and conjunctival melanoma: a 14-year study at the Jules Gonin Eye Hospital

Orbital exenteration and conjunctival melanoma: a 14-year study at the Jules Gonin Eye Hospital

Skin and Bone: Intact Fish Skin to Reconstruct Traumatic Orbital Floor and Wall Defects

Isolated Ophthalmoplegia After Periorbital Hyaluronic Acid Filler Injection

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