Orbital Exenteration: A 23-year Report
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Purpose: Orbital exenteration is a psychologically and anatomically disfiguring procedure which indicated insome patients with malignant or progressive diseases of orbital and periorbital area. In this study, we reviewed176 patients that underwent orbital exenteration. Methods: This was a retrospective study of medical records from all patients who underwent orbital exenterationfrom March 1991 to March 2014 in oculoplastic department at an eye care center. Demographic data,diagnosis, site of primary involvement and technique of surgery were determined in patients. Results: One hundred seventy-six cases of orbital exenteration were included that had documented histopathology. The age of patients ranged from 1 to 91 years (mean age ± standard deviation, 55.43 ± 27 years). Ninety-seven (55.11%) males and 79 (44.88%) females were included. Fifteen different tumors were identified. Themost common indication was patients with basal cell carcinoma 49 (28%) followed by 41 (23.5%) squamouscell carcinomas, 35 (20%) retinoblastoma, and 13 (7%) adenoid cystic carcinomas. In total, adnexal malignancieswere the most common tumors, secondarily involving the orbit. Eyelids 89 (50.5%) and the globe 43 (24%)were the most frequent site of involvement. Three types of exenteration were performed, based on availabledata of 129 operation sheets, 46 (35.7%) subtotal, 62 (48.1%) total, and 21 (16.3%) cases of extensive exenterations. In total 97 cases were evaluated pathologically for perineural involvement, of which perineural invasionwas noted in 9 (7%) reports. Conclusions: Frequency of exenteration in our center has increased in past 3 years and the majority of caseswere eyelid basal cell carcinoma. Patient education considering periocular lesions can help in earlier diagnosisof malignant lesions and therefore reducing the number of exenteration.
Abstract
Purpose: Orbital exenteration is a psychologically and anatomically disfiguring procedure which indicated insome patients with malignant or progressive diseases of orbital and periorbital area. In this study, we reviewed176 patients that underwent orbital exenteration. Methods: This was a retrospective study of medical records from all patients who underwent orbital exenterationfrom March 1991 to March 2014 in oculoplastic department at an eye care center. Demographic data,diagnosis, site of primary involvement and technique of surgery were determined in patients. Results: One hundred seventy-six cases of orbital exenteration were included that had documented histopathology. The age of patients ranged from 1 to 91 years (mean age ± standard deviation, 55.43 ± 27 years). Ninety-seven (55.11%) males and 79 (44.88%) females were included. Fifteen different tumors were identified. Themost common indication was patients with basal cell carcinoma 49 (28%) followed by 41 (23.5%) squamouscell carcinomas, 35 (20%) retinoblastoma, and 13 (7%) adenoid cystic carcinomas. In total, adnexal malignancieswere the most common tumors, secondarily involving the orbit. Eyelids 89 (50.5%) and the globe 43 (24%)were the most frequent site of involvement. Three types of exenteration were performed, based on availabledata of 129 operation sheets, 46 (35.7%) subtotal, 62 (48.1%) total, and 21 (16.3%) cases of extensive exenterations. In total 97 cases were evaluated pathologically for perineural involvement, of which perineural invasionwas noted in 9 (7%) reports. Conclusions: Frequency of exenteration in our center has increased in past 3 years and the majority of caseswere eyelid basal cell carcinoma. Patient education considering periocular lesions can help in earlier diagnosisof malignant lesions and therefore reducing the number of exenteration.
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