An algorithmic approach to reconstructive surgery and prosthetic rehabilitation after orbital exenteration

Plastic and Reconstructive Surgery
Matthew M HanasonoBita Esmaeli

Abstract

The authors' goal was to describe an algorithm for surgical reconstruction and prosthetic rehabilitation after orbital exenteration. A review of 79 patients who underwent orbital exenteration between 1999 and 2007 was performed. Reconstructions were classified as resulting in an "open" cavity when a concave orbital socket facilitating prosthetic retention was created or a "closed" cavity when the orbit was filled with soft tissue to the level of the orbital rim. Reconstructive procedures included skin grafts (n = 18), regional flaps (n = 6), and microvascular free flaps (n = 55). Open cavities were created in 34 patients and closed cavities were created in 45 patients. Twenty-one patients (27 percent) experienced surgical complications. There were no significant differences in complication rates among various reconstructive techniques (skin graft versus regional flap versus free flap) or types of cavities created (open versus closed). Of the 17 patients who use prostheses, eight (47 percent) wear their prostheses regularly. Fourteen patients (82 percent) who received an orbital prosthesis had open cavities (p = 0.001). Thirty-nine percent of patients with a skin graft received orbital prostheses, and 17 percent with a regional ...Continue Reading

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