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Reyes-Soto G, Carrillo-Hernández JF, Cacho-Díaz B, Ovalle CS, Castillo-Rangel C, Nurmukhametov R, Chmutin G, Ramirez MDJE, Montemurro N. Surgical treatment of orbital tumors in a single center: Analysis and results. Surg Neurol Int 2024; 15:122. [PMID: 38741993 PMCID: PMC11090600 DOI: 10.25259/sni_1016_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/15/2024] [Indexed: 05/16/2024] Open
Abstract
Background Orbital tumors, arising within the bony orbit and its contents, present diverse challenges due to their varied origins and complex anatomical context. These tumors, classified as primary, secondary, or metastatic, are further subdivided into intraconal and extraconal based on their relationship with the muscle cone. This classification significantly influences surgical approach and management. This study highlights surgical experiences with orbital tumors, underscoring the importance of tailored surgical approaches based on the lesion's site and its proximity to the optic nerve. Methods This retrospective study at the National Institute of Cancer's Head and Neck Department (2005-2014) analyzed 29 patients with orbital tumors treated with surgery, radiotherapy, chemotherapy, or combinations of them. Patient demographics, tumor characteristics, and treatment responses were evaluated using computed tomography (CT), magnetic resonance imaging, and positron emission tomography-CT imaging. Malignant tumors often required orbital exenteration and reconstruction, highlighting the study's commitment to advancing orbital tumor treatment. Results 29 patients (18 females and 11 males, age 18-88 years, mean 53.5 years) with orbital tumors exhibited symptoms such as decreased vision and exophthalmos. Tumors included primary lesions like choroidal melanoma and secondary types like epidermoid carcinoma. Treatments varied, involving a multidisciplinary team for surgical approaches like exenteration, with follow-up from 1 to 9 years. Radiotherapy and chemotherapy were used for specific cases. Conclusion Our study underscores the need for a multidisciplinary approach in treating orbital tumors, involving various surgical specialists and advanced technologies like neuronavigation for tailored treatment. The integration of surgery with radiotherapy and chemotherapy highlights the effectiveness of multidimensional treatment strategies.
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Affiliation(s)
- Gervith Reyes-Soto
- Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Jose F. Carrillo-Hernández
- Department of Investigación Biomédica, Unidad de Investigación Biomédica en Cáncer, Laboratorio de Genómica, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Bernardo Cacho-Díaz
- Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | - Carlos Castillo-Rangel
- Department of Neurosurgery, Servicio of the 1ro de Octubre Hospital of the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Instituto Politécnico Nacional, México City, Mexico
| | - Renat Nurmukhametov
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
| | - Gennady Chmutin
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
| | | | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
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Puar JK, Narang V, Kaur J. Augmented reality filters for iris positioning in orbital prosthesis: A clinical report. J Prosthet Dent 2023:S0022-3913(23)00573-5. [PMID: 37806943 DOI: 10.1016/j.prosdent.2023.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 10/10/2023]
Abstract
Mid-facial defects involving the eye can result in severe emotional and psychological trauma for the affected individual, apart from the loss of vision. Prosthetic rehabilitation with an orbital prosthesis can camouflage such defects when surgical treatments are limited. The fabrication of an orbital prosthesis requires precise positioning of the iris for an optimal esthetic outcome. Different techniques for accurate iris positioning in orbital or ocular prostheses have been described, but they have been subjective or require elaborate equipment. This clinical report describes a novel and digital solution for iris positioning with the help of augmented reality filters using a smartphone and Instagram app.
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Affiliation(s)
- Jasleen Kaur Puar
- Postgraduate Resident, Department of Prosthodontics and Crown & Bridge, Baba Jaswant Singh Dental College, Hospital & Research Institute, Ludhiana, India.
| | - Vishwas Narang
- Assistant Professor, Department of Prosthodontics and Crown & Bridge, Baba Jaswant Singh Dental College, Hospital & Research Institute, Ludhiana, India
| | - Jaswinder Kaur
- Professor, Department of Prosthodontics and Crown & Bridge, Baba Jaswant Singh Dental College, Hospital & Research Institute, Ludhiana, India
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Slijepcevic AA, Afshari A, Vitale AE, Couch SM, Jeanpierre LM, Chi JJ. A Contemporary Review of the Role of Facial Prostheses in Complex Facial Reconstruction. Plast Reconstr Surg 2023; 151:288e-298e. [PMID: 36696329 DOI: 10.1097/prs.0000000000009856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Maxillofacial prostheses provide effective rehabilitation of complex facial defects as alternatives to surgical reconstruction. Although facial prostheses provide aesthetically pleasing reconstructions, multiple barriers exist that prevent their routine clinical use. The accessibility of facial prostheses is limited by the scarce supply of maxillofacial prosthodontists, significant time commitment and number of clinic appointments required of patients during prosthesis fabrication, short lifespan of prostheses, and limited outcomes data. METHODS A literature review was completed using PubMed and Embase databases, with search phrases including face and maxillofacial prostheses. Patient cases are included to illustrate the use of facial prostheses to reconstruct complex facial defects. RESULTS The clinical use of facial prostheses requires a multidisciplinary team including a reconstructive surgeon, a maxillofacial prosthodontist, and an anaplastologist, if available, to provide patients with aesthetically appropriate facial prostheses. Developing technology including computer-aided design and three-dimensional printing may improve the availability of facial prostheses by eliminating multiple steps during prosthesis fabrication, ultimately decreasing the time required to fabricate a prosthesis. In addition, enhanced materials may improve prosthesis durability. Long-term outcomes data using validated measures is needed to support the continued use of facial prostheses. CONCLUSIONS Facial prostheses can be used to reconstruct complex facial defects, and bone-anchored prostheses are associated with high patient satisfaction. Multiple barriers prevent prostheses from being used for facial reconstruction. New technologies to assist the design and fabrication of prostheses, and cost reduction measures, may allow their use in the appropriately selected patient.
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Affiliation(s)
| | - Azadeh Afshari
- Division of Maxillofacial Prosthodontics, Barnes-Jewish Hospital
| | - Ann E Vitale
- Division of Maxillofacial Prosthodontics, Barnes-Jewish Hospital
| | | | | | - John J Chi
- Division of Facial Plastic and Reconstructive Surgery, Washington University in St. Louis
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Martel A, Baillif S, Nahon-Esteve S, Gastaud L, Bertolotto C, Lassalle S, Lagier J, Hamedani M, Poissonnet G. Orbital exenteration: an updated review with perspectives. Surv Ophthalmol 2021; 66:856-876. [PMID: 33524457 DOI: 10.1016/j.survophthal.2021.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 01/15/2023]
Abstract
Orbital exenteration is a radical and disfiguring surgery mainly performed in specialized tertiary care centers. Orbital exenteration has long been considered the treatment of choice for managing periocular tumors invading the orbit or primary orbital malignancies. Over the past decades, attention has been directed toward reducing the perioperative morbidity by developing new surgical devices and new strategies and promoting cosmetic rehabilitation by providing adequate facial prostheses. Despite these advances, several studies have questioned the role of orbital exenteration in improving overall survival. The last decade has been marked by the emergence of a new paradigm: the "eye-sparing" strategies based on conservative surgery with or without adjuvant radiotherapy and/or targeted therapies and immunotherapies. We summarize the data on orbital exenteration, including epidemiology, etiologies, use of surgical ablative and reconstructive techniques, complications, outcomes, and the related controversies.
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Affiliation(s)
- Arnaud Martel
- Université Côte d'Azur, Ophthalmology department, Centre Hospitalier Universitaire de Nice, Nice, France.
| | - Stephanie Baillif
- Université Côte d'Azur, Ophthalmology department, University Hospital of Nice, Nice, France
| | - Sacha Nahon-Esteve
- Université Côte d'Azur, Ophthalmology department, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Lauris Gastaud
- Oncology department, Antoine Lacassagne Cancer Centre, Nice, France
| | | | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology and Biobank BB-0033-00025, Nice, France
| | - Jacques Lagier
- Université Côte d'Azur, Ophthalmology department, University Hospital of Nice, Nice, France
| | - Mehrad Hamedani
- Oculoplastic department, Jules Gonin Eye hospital, Lausanne, Switzerland
| | - Gilles Poissonnet
- Cervico-facial department, Institut Universitaire de la Face et du Cou, Nice, France
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Goiato MC, Dos Santos DM, de Sousa Ervolino IC, Brunetto JL, de Magalhaes Bertoz AP, de Moraes Melo Neto CL. Prostetic Rehabilitation of an Eye Globe: Case Report. Med Arch 2020; 73:433-435. [PMID: 32082015 PMCID: PMC7007609 DOI: 10.5455/medarh.2019.73.433-435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Introduction The lack of an eye has an immediate and long-term impact on a patient's life. Aim The aim of this study is to show a case of prosthetic rehabilitation of an eyeball. Case report Male patient, 60 years old, sought care at the Oral Oncology Center of the São Paulo State University "Júlio de Mesquita Filho", for the rehabilitation of the orbital cavity with an acrylic eye prosthesis. This prosthesis was made with thermopolymerizable acrylic resin and hand painted iris with oil paint on cardboard. The prosthesis was installed after finishing and polishing and the hygiene and general care instructions were explained. Conclusion In the present case, the patient was satisfied with the aesthetics and comfort of the prosthesis, which demonstrates the success of the treatment.
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Affiliation(s)
- Marcelo Coelho Goiato
- Department of Dental Materials and Prosthodontics, Sao Paulo State University (Unesp), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Daniela Micheline Dos Santos
- Department of Dental Materials and Prosthodontics, Sao Paulo State University (Unesp), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Isabela Caroline de Sousa Ervolino
- Department of Dental Materials and Prosthodontics, Sao Paulo State University (Unesp), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Juliana Lujan Brunetto
- Department of Dental Materials and Prosthodontics, Sao Paulo State University (Unesp), School of Dentistry, Aracatuba, São Paulo, Brazil
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Nuseir A, Hatamleh MM, Alnazzawi A, Al-Rabab'ah M, Kamel B, Jaradat E. Direct 3D Printing of Flexible Nasal Prosthesis: Optimized Digital Workflow from Scan to Fit. J Prosthodont 2018; 28:10-14. [PMID: 30461125 DOI: 10.1111/jopr.13001] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2018] [Indexed: 01/28/2023] Open
Abstract
A maxillofacial prosthesis is a successful treatment modality to restore missing facial parts. Digital technologies and 3D printing are employed in constructing facial prostheses such as ears; however, their application is still partial, and final prostheses are usually manufactured conventionally using stone molds. This report aims to introduce a complete digital workflow to construct a nasal prosthesis and compare it to the conventional workflow of a patient requiring a nasal prosthesis. A computer tomography scan showing the defect was exported to specialized software to create 3D reconstructions of the patient's face and underlying bone. The nose was digitally designed restoring facial esthetics, anatomy, shape, and skin color. Different skin tones were digitally matched to skin tissues adjacent to the defect area using the Spectromatch system. The design was 3D printed in flexible and colorful material at 16 μm resolution using a 3D printer. External color pigmentations were applied to the nose for optimum esthetics, and the prosthetic nose was sealed in silicone and left to heat polymerize for 15 minutes. The prosthetic nose was retained in place using biomedical adhesive, and the patient was pleased with it. This report proposes a complete digital workflow to directly design and fabricate a prosthetic nose of acceptable esthetics. Such a workflow can lead to enhanced prosthesis reproducibility and acceptability and may become an effective treatment option for treatment of patients with facial defects.
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Affiliation(s)
- Amjad Nuseir
- Faculty of Medicine, Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, Jordan
| | - Muhanad Moh'd Hatamleh
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Foundation Trust, London, UK.,Luminous Technical University College, Amman, Jordan
| | - Ahmad Alnazzawi
- Department of Substitutive Dental Science, Faculty of Dentistry, Taibah University, Madinah, Saudi Arabia
| | - Mohammad Al-Rabab'ah
- University of Jordan, School of Dentistry, Amman, Jordan.,University of Liverpool, School of Dentistry, Liverpool, UK
| | - Belal Kamel
- Plastic Surgery Specialist, Nour Clinic, Cairo, Egypt
| | - Esraa Jaradat
- Department of Allied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Kaur H, Nanda A, Verma M, Mutneja P, Koli D, Bhardwaj S. Prosthetic rehabilitation of resected orbit in a case of mucormycosis. J Indian Prosthodont Soc 2018; 18:364-369. [PMID: 30449965 PMCID: PMC6180739 DOI: 10.4103/jips.jips_53_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022] Open
Abstract
The design of orbital prosthesis to rehabilitate patients with orbital exenteration depends on the underlying clinical condition, material chosen for prosthesis, method of retention of the prosthesis, and and preference of the patient. Rehabilitation of a patient with orbital exenteration due to mucormycosis has been described by fabricating a prosthesis that used polymethyl methacrylate (to fabricate a conformer) and silicone material (to fabricate prosthetic superstructure). The two-component prosthesis was designed to attain dual mechanical retention using an anatomic undercut (conformer) and manually created mechanical undercut (prosthetic superstructure). The objective was to maintain the biological health of the underlying postsurgical tissue, longevity of the prosthesis, optimal esthetics, and adequate retention.
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Affiliation(s)
- Harsimran Kaur
- Senior Research Associate, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Aditi Nanda
- Senior Research Associate, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Mahesh Verma
- Director-Principal, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Parul Mutneja
- Dental Surgeon, Safdarjung Hospital, New Delhi, India
| | - Dheeraj Koli
- Assistant Professor, All India Institute of Medical Sciences, New Delhi, India
| | - Smiti Bhardwaj
- Senior Research Associate, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Survey of Ocular Prosthetics Rehabilitation in the United Kingdom, Part 2: Anophthalmic Patients' Satisfaction and Acceptance. J Craniofac Surg 2018; 28:1297-1301. [PMID: 28582288 DOI: 10.1097/scs.0000000000003656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
AIM Ocular prostheses are integral for anophthalmic patients. Part 1 of this study reported that patients' aetiology, opinions, and attitudes significantly affected their prosthetic eyes experience. Part 2 investigates the patient satisfaction and acceptance in light of some of the aetiological demographics reported in Part 1. METHODOLOGY One hundred sixty questionnaires were delivered to anophthalmic patients attending oculoplastic clinic. Etiological aspects presented in the questionnaire were disseminated in part 1. Patient satisfaction was assessed through 8 closed-end statements reflecting aspects concerning patient's views on prosthesis comfort and appearance; patient's expectations, self-esteem, and perception; and cooperation with ocularist. Each statement had 3 categories as agree, moderately agree, and disagree. A total of 126 questionnaires were returned (response rate was 78.8%). Data was analyzed using SPSS software. Association coefficients and correlations between variables were also analyzed. RESULTS Total number of responses for the 8 statements was 888, averaging of 111 (expected 126) respondent per statement. Overall, 95.4% of our patients agreed with all satisfaction statements presented echoing very high satisfaction rate with their ocular prosthetics. Having an eye replacement that covers the defect is associated with high satisfaction among patients regardless of ocular prosthetic type. Patient acceptance of prosthesis in relation to employment status was high but not the same among the different categories (P > 0.05). High satisfaction with ocular prosthetics was prevalent among both genders, but there were no statistically significant differences in percentages of agreement in all statements (P > 0.05). Satisfaction and acceptance with ocular prosthetics was the same among all age groups of 12 to 85 years old (P > 0.05). CONCLUSIONS The patient satisfaction is associated with the interplay of different variables that is related to ocular prosthesis design and its ability to disguise disfigurement (ie, prosthesis shape, resemblance to existing contra-lateral eye, etc.); patients themselves (ie, gender, age, occupation, marital status, etc); and psychological well-being and social support provided. Anophthalmic patients of the north west of England are significantly happy with their ocular prosthetic rehabilitation and support they receive from their regional hospital. Ocular prosthetics enhances their psychological well-being and social interaction and factors like patients' sex, age, employment status, and type of ocular prosthesis have no effect on their acceptance and satisfaction.
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9
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Hatamleh MM, Abbariki M, Alqudah N, Cook AE. Survey of Ocular Prosthetics Rehabilitation in the United Kingdom, Part 1. J Craniofac Surg 2017; 28:1293-1296. [DOI: 10.1097/scs.0000000000003370] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Fabrication of an Orbital Prosthesis Combined With Eyebrow Transplantation. J Craniofac Surg 2017; 28:479-481. [PMID: 28045822 DOI: 10.1097/scs.0000000000003319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Fabrication of an orbital prosthesis is considered as a challenging procedure as compared to the other facial prosthesis due to the presence of inactive eye movements and the need of artificial hair in order to mimic eyelashes and eyebrows. Generally these structures are sewed or bonded in the silicone. However, deformation or hair loss is observed within time. This deformation is visible especially in the eyebrow. This clinical report represents a patient with an implant supported orbital prosthesis. Patient was not satisfied with the nature of her eyebrow that was sewed in the silicone. Therefore, an alternative approach of eyebrow transplantation was used for the patient. The patient expressed her better satisfaction of this definitive prosthesis supported with eyebrow transplantation.
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Santacruz Benítez GA, Díaz Aguirre CM, García Becerra RM, Aguilar Garza GD, Lara Gutiérrez CA. Prótesis combinada con retención magnética: presentación de un caso clínico. GACETA MEXICANA DE ONCOLOGÍA 2016. [DOI: 10.1016/j.gamo.2016.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Kuiper JJ, Zimmerman MB, Pagedar NA, Carter KD, Allen RC, Shriver EM. Perception of patient appearance following various methods of reconstruction after orbital exenteration. Orbit 2016; 35:187-192. [PMID: 27341072 DOI: 10.1080/01676830.2016.1176207] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This article compares the perception of health and beauty of patients after exenteration reconstruction with free flap, eyelid-sparing, split-thickness skin graft, or with a prosthesis. Cross-sectional evaluation was performed through a survey sent to all students enrolled at the University of Iowa Carver College of Medicine. The survey included inquiries about observer comfort, perceived patient health, difficulty of social interactions, and which patient appearance was least bothersome. Responses were scored from 0 to 4 for each method of reconstruction and an orbital prosthesis. A Friedman test was used to compare responses among each method of repair and the orbital prosthesis for each of the four questions, and if this was significant, then post-hoc pairwise comparison was performed with p values adjusted using Bonferroni's method. One hundred and thirty two students responded to the survey and 125 completed all four questions. Favorable response for all questions was highest for the orbital prosthesis and lowest for the split-thickness skin graft. Patient appearance with an orbital prosthesis had significantly higher scores compared to patient appearance with each of the other methods for all questions (p value < 0.0001). Second highest scores were for the free flap, which were higher than eyelid-sparing and significantly higher compared to split-thickness skin grafting (p value: Question 1: < 0.0001; Question 2: 0.0005; Question 3: 0.006; and Question 4: 0.019). The orbital prosthesis was the preferred post-operative appearance for the exenterated socket for each question. Free flap was the preferred appearance for reconstruction without an orbital prosthesis. Split-thickness skin graft was least preferred for all questions.
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Affiliation(s)
- Justin J Kuiper
- a Carver College of Medicine, University of Iowa , Iowa City , Iowa , USA
| | - M Bridget Zimmerman
- b Department of Biostatistics , University of Iowa College of Public Health , Iowa City , Iowa , USA
| | - Nitin A Pagedar
- c University of Iowa Hospitals and Clinics , Iowa City , Iowa , USA
| | - Keith D Carter
- c University of Iowa Hospitals and Clinics , Iowa City , Iowa , USA
| | - Richard C Allen
- c University of Iowa Hospitals and Clinics , Iowa City , Iowa , USA
| | - Erin M Shriver
- c University of Iowa Hospitals and Clinics , Iowa City , Iowa , USA
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