Orbital exenteration: surgical and reconstructive strategies

Abstract

Background: Radical exenteration procedures, which include the removal of orbital content and eyelids, result in serious functional limitations, especially with respect to eating and speaking. Therefore we have recently changed our surgical concept.

Methods: Seventy-seven patients underwent orbital exenteration during the 20-year period from 1974 to 1995 at the Department of Maxillofacial Surgery, Essen University. The simultaneous removal of periorbital bone was performed in 45 of these cases.

Results: The 1-year survival rate was 89%, the 5-year rate was 63% and the 10-year rate was 48%. The surgical approach, the amount of resected orbital tissue and the reconstructive procedure have been adapted to the individual needs, depending on the location and extent of the tumor. Subsequently, the surgical morbidity has decreased.

Discussion: Detailed consideration of all clinical and histological findings is essential before surgery, in order to prevent a higher rate of recurrence following these modified operations.