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Considerations in Orbital Reconstruction for the Oncologic Surgeon: Critical versus Optimal Objectives
Background Orbital reconstruction following oncologic midface resection is uniquely challenging, and makes critical contributions to patient aesthetics, function, and identity. Approach is largely dependent on surgeon and patient preferences, and there exists no consensus on defect characterization....
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Thieme Medical and Scientific Publishers Private Ltd.
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785328/ https://www.ncbi.nlm.nih.gov/pubmed/31602141 http://dx.doi.org/10.1055/s-0039-1696624 |
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author | Legocki, Alex T. Miles, Brett A. |
author_facet | Legocki, Alex T. Miles, Brett A. |
author_sort | Legocki, Alex T. |
collection | PubMed |
description | Background Orbital reconstruction following oncologic midface resection is uniquely challenging, and makes critical contributions to patient aesthetics, function, and identity. Approach is largely dependent on surgeon and patient preferences, and there exists no consensus on defect characterization. Objective The goal of the study is to provide a mental framework for the reconstructive oncologic surgeon to use as a foundation during his or her approach to the orbit. Design The design of the study is based on the review of current literature and expert opinion. Conclusions Critical versus optimal objectives must be set in orbital reconstruction, and a systematic approach should be followed. We approach orbital reconstruction by first deciding whether globe-sparing surgery is possible, or if orbital exenteration will be necessary. We then set critical and optimal objectives for our chosen pathway. Critical goals in globe-sparing reconstruction include maintaining orbital volume and preserving visual function, and an optimal goal includes preservation of the nasolacrimal system. Critical goals in orbital exenteration include obliterating the defect, sealing the skull base and nasal cavities, and allowing eye protection to be worn over the contralateral eye postoperatively. Optimal goals in exenteration include preparation for prosthetics, volume and bony replacement, eyelid-sparing technique, and consideration of postoperative radiation. |
format | Online Article Text |
id | pubmed-6785328 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Thieme Medical and Scientific Publishers Private Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-67853282019-10-10 Considerations in Orbital Reconstruction for the Oncologic Surgeon: Critical versus Optimal Objectives Legocki, Alex T. Miles, Brett A. Indian J Plast Surg Background Orbital reconstruction following oncologic midface resection is uniquely challenging, and makes critical contributions to patient aesthetics, function, and identity. Approach is largely dependent on surgeon and patient preferences, and there exists no consensus on defect characterization. Objective The goal of the study is to provide a mental framework for the reconstructive oncologic surgeon to use as a foundation during his or her approach to the orbit. Design The design of the study is based on the review of current literature and expert opinion. Conclusions Critical versus optimal objectives must be set in orbital reconstruction, and a systematic approach should be followed. We approach orbital reconstruction by first deciding whether globe-sparing surgery is possible, or if orbital exenteration will be necessary. We then set critical and optimal objectives for our chosen pathway. Critical goals in globe-sparing reconstruction include maintaining orbital volume and preserving visual function, and an optimal goal includes preservation of the nasolacrimal system. Critical goals in orbital exenteration include obliterating the defect, sealing the skull base and nasal cavities, and allowing eye protection to be worn over the contralateral eye postoperatively. Optimal goals in exenteration include preparation for prosthetics, volume and bony replacement, eyelid-sparing technique, and consideration of postoperative radiation. Thieme Medical and Scientific Publishers Private Ltd. 2019-05 2019-08-29 /pmc/articles/PMC6785328/ /pubmed/31602141 http://dx.doi.org/10.1055/s-0039-1696624 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Legocki, Alex T. Miles, Brett A. Considerations in Orbital Reconstruction for the Oncologic Surgeon: Critical versus Optimal Objectives |
title | Considerations in Orbital Reconstruction for the Oncologic Surgeon: Critical versus Optimal Objectives |
title_full | Considerations in Orbital Reconstruction for the Oncologic Surgeon: Critical versus Optimal Objectives |
title_fullStr | Considerations in Orbital Reconstruction for the Oncologic Surgeon: Critical versus Optimal Objectives |
title_full_unstemmed | Considerations in Orbital Reconstruction for the Oncologic Surgeon: Critical versus Optimal Objectives |
title_short | Considerations in Orbital Reconstruction for the Oncologic Surgeon: Critical versus Optimal Objectives |
title_sort | considerations in orbital reconstruction for the oncologic surgeon: critical versus optimal objectives |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785328/ https://www.ncbi.nlm.nih.gov/pubmed/31602141 http://dx.doi.org/10.1055/s-0039-1696624 |
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