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Rhabdomyosarcoma
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Gideon Sandler, Andrea Hayes-Jordan
Orbital tumors should be biopsied with the help of an ophthalmologist. Orbital exenteration is reserved for the few patients who have refractory or recurrent disease. In the interests of preserving vision, RT should be limited to the conjunctiva, cornea, and lens. Survival is 90–95%.
Adult Ocular and Orbital (Ocular Adnexa) Tumors
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
P.N. Plowman, Rachel Lewis, J.L. Hungerford
Malignant neurogenic tumors of neural crest origin may arise de novo or may develop in a pre-existing benign tumor, particularly in association with neurofibromatosis. Malignant schwannoma is an infiltrative tumor that tends to grow along neural channels and to present with pain. Local surgical excision is frequently followed by recurrence, and orbital exenteration may be required. Persistent local recurrence may be managed by radiotherapy. Death may occur from direct intra-cranial extension or from distant metastases.
Sinonasal tumours
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Yujay Ramakrishnan, Shahzada Ahmed
Orbital exenteration refers to complete removal of the contents of the orbit including the eyelids. Orbital clearance refers to removal of the globe, muscles and periorbita, whilst the eyelids and palpebral conjunctiva are preserved [16]. Orbital clearance is more commonly performed.
Psychosocial factors among patients undergoing orbital exenteration
Published in Clinical and Experimental Optometry, 2023
Neelima Balakrishnan, Sahil Agrawal, Rachna Bhargava, Veena Jain, Neelam Pushker, Rachna Meel, Mandeep S. Bajaj
Destructive procedures performed to treat facial malignancies come with specific challenges of their own due to the added psychological trauma of disfigurement of the face.1 The procedures have been shown to have a negative impact on the social, emotional, personal and financial well-being of the patient.2 Orbital exenteration is still the surgery of choice in locally advanced orbital malignancies. The diagnosis of cancer is itself associated with increased levels of anxiety and depression and a lowered overall quality of life.1 Additionally, persistent and chronic depression in cancer patients has been shown to be associated with lower survival rates.3 Studies are available on the psychosocial aspects of procedures such as enucleation and evisceration.1–3 However, limited literature is available on the impact of orbital exenteration on the psychosocial well-being of the patient and need of a psychologist as a part of treatment in such patients.2
Locally advanced sinonasal adenoid cystic carcinomas: endoscopic endonasal surgery-centered comprehensive treatment provides benefits
Published in Acta Oto-Laryngologica, 2023
Jin Wang, Meng Zhang, Wenqi Yi, Liang Li, Liangyu Li, Chuan Pang, Lei Chen
Orbital invasion is a typical pattern of locally advanced SNACCs (Figure 3). In patients harboring sinus malignancies, orbital invasion via the periorbita is generally associated with poorer OS and DFS rates. Indeed, orbital invasion is associated with worse patients outcomes even following salvage surgery, with reported 5-year survival rate was no more than 40% in patients exhibiting orbital invasion [12]. Orbital exenteration is a procedure that is frequently performed for patients exhibiting tumor invasion of sinus structures, particularly in cases of the medial rectus muscle, optic nerve, or ocular bulb invasion. However, the benefits of this procedure to patients OS or DFS remain unclear, particularly in individuals with residual visual function. As orbital exenteration was not performed in this study, the survival benefits of our procedures were not assessed. However, we achieved orbital tumor recurrence rates of just 13% (3/23), and the total rate of local recurrence (7/44) was not significantly associated with the 5-year OS of patients, indicating that orbital resection may not be so radical during EES for locally advanced SNACCs.
Transcutaneous retrobulbar injection of amphotericin B in rhino-orbital-cerebral mucormycosis: a review
Published in Orbit, 2022
Akshay Gopinathan Nair, Tarjani Vivek Dave
Controlling the underlying immunodeficiency condition is the foremost step in the management of ROCM. Simultaneously, intravenous antifungal medications and endoscopic sinus debridement with adjuvant local intraoperative amphotericin B (AMB) administration are considered the standard of care in ROCM.14 Orbital exenteration is typically recommended in patients who show progression of disease in spite of medical and surgical treatments.14,15 In the literature, indications for orbital exenteration have included ophthalmoplegia, proptosis, cranial involvement, and ocular involvement.16–21 Some have even reported that exenteration could increase patients’ survival in the presence of intracranial spread and rapid progression.18 At the same time, it has also been reported that orbital exenteration, by itself, does not affect the patients’ survival in ROCM.15 A possible explanation being that orbital exenteration is typically performed for patients in the end-stage disease.15,19 Hence, it was noted that no standard of care currently exists to guide physicians on when exenteration may benefit a mucormycosis patient.22 In summary, there are no clear guidelines for the effective management of the orbital component in ROCM.23