Craneofacial approach in orbital tumors

Introduction: Surgery for orbital lesions usually show a high degree of complexity that in many cases requires a comprehensive approach undertaken by a multidisciplinary team. The large skull base defects, resulting from tumor resection, create direct communication spaces with the risk of infections, fistulas and cerebral herniation, so it must be suitable reconstruction.

Materials and methods: We present ten cases of orbital tumors, operated since 2006–2010. Five patients diagnosed as benign lesions: fibrous dysplasia, simple bone cyst and a cavernous angioma. The most frequent malignant tumor was squamous cell carcinoma.

Results: The resection was performed with clear margins in all cases. There were no immediate complications, except one case of fistula of cerebrospinal fluid that resolved with conservative measures. There has been no local recurrence in any case. Postoperative radiotherapy was taken in the case of malignances. There was a case of death and another loss monitoring.

Discussion: The most common manifestations of the injuries were ocular dystopia, proptosis, diplopia and visual field deficits. The treatment of choice was wide excision, through a craniotomy, obtaining a pericranial galeal flap useful for the subsequent seal the cranial cavity. The inner table of the frontal bone have been used as a source of autogenous bone graft. Depending on the type of the defect, we have performed microsurgical and local flaps.

Conclusions: In the orbital injuries extending to the base of the skull, craniofacial approach usually allows adequate resection with few complications and good cosmetic and functional result.

Conflict of interest : None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Craneofacial approach in orbital tumors

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