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Dragosloveanu S, Petre MA, Capitanu BS, Dragosloveanu CDM, Cergan R, Scheau C. Initial Learning Curve for Robot-Assisted Total Knee Arthroplasty in a Dedicated Orthopedics Center. J Clin Med 2023; 12:6950. [PMID: 37959414 PMCID: PMC10649181 DOI: 10.3390/jcm12216950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/30/2023] [Accepted: 11/04/2023] [Indexed: 11/15/2023] Open
Abstract
Background and objectives: Our study aimed to assess the learning curve for robot-assisted (RA) total knee arthroplasty (TKA) in our hospital, compare operative times between RA-TKAs and manual TKAs, and assess the early complications rate between the two approaches. Methods: We included 39 patients who underwent RA-TKA and 45 control patients subjected to manual TKA in the same period and operated on by the same surgical staff. We collected demographic and patient-related data to assess potential differences between the two groups. Results: No statistical differences were recorded in regard to age, BMI, sex, Kellgren-Lawrence classification, or limb alignment between patients undergoing RA-TKA and manual TKA, respectively. Three surgeons transitioned from the learning to the proficiency phase in our study after a number of 6, 4, and 3 cases, respectively. The overall operative time for the learning phase was 111.54 ± 20.45 min, significantly longer compared to the average of 86.43 ± 19.09 min in the proficiency phase (p = 0.0154) and 80.56 ± 17.03 min for manual TKAs (p < 0.0001). No statistically significant difference was recorded between the global operative time for the proficiency phase TKAs versus the controls. No major complications were recorded in either RA-TKA or manual TKA groups. Conclusions: Our results suggest that experienced surgeons may adopt RA-TKA using this platform and quickly adapt without significant complications.
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Affiliation(s)
- Serban Dragosloveanu
- The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Orthopaedics, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Mihnea-Alexandru Petre
- Department of Orthopaedics, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Bogdan Sorin Capitanu
- Department of Orthopaedics, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Christiana Diana Maria Dragosloveanu
- The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Romica Cergan
- The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Radiology and Medical Imaging, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Cristian Scheau
- The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Radiology and Medical Imaging, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
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Păsărică MA, Curcă PF, Burcea M, Schmitzer S, Dragosloveanu CDM, Grigorescu AC. The Effects of Oncological Treatment on Redox Balance in Patients with Uveal Melanoma. Diagnostics (Basel) 2023; 13:diagnostics13111907. [PMID: 37296758 DOI: 10.3390/diagnostics13111907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: Uveal malignant melanoma is the most common adult eye cancer and presents metabolic reprogramming that affects the tumoral microenvironment by altering the redox balance and producing oncometabolites. (2) Methods: The study prospectively evaluated patients undergoing enucleation surgery or stereotactic radiotherapy for uveal melanoma by following systemic oxidative-stress redox markers serum lipid peroxides, total albumin groups and total antioxidant levels (3) Results: Serum antioxidants and lipid peroxides were elevated from pre-treatment to longer-term follow-up. Antioxidants inversely correlated to lipid peroxides: higher in stereotactic radiosurgery patients pre/6/12/18 months post-treatment (p = 0.001-0.049) versus higher lipid peroxides in enucleation surgery patients pre/after/6 months post-treatment (p = 0.004-0.010). An increased variance in serum antioxidants was observed for enucleation surgery patients (p < 0.001), however enucleation did not increase mean serum antioxidants or albumin thiols; only lipid peroxides were increased post-enucleation (p < 0.001) and at 6-month follow-up (p = 0.029). Mean albumin thiols were increased for 18- and 24-month follow-ups (p = 0.017-0.022). Males who had enucleation surgery presented higher variance in serum determinations and overall higher lipid peroxides values pre/post-treatment and at the 18-month follow-up. (4) Conclusions: Initial oxidative stress-inducing events of surgical enucleation or stereotactic radiotherapy for uveal melanoma are followed by a longer-term inflammatory cascade gradually subsiding at later follow-ups.
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Affiliation(s)
- Mihai Adrian Păsărică
- Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Paul Filip Curcă
- Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Marian Burcea
- Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Speranța Schmitzer
- Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Christiana Diana Maria Dragosloveanu
- Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Alexandru Călin Grigorescu
- Department of Oncology, Institute of Oncology Prof. Dr. Alexandru Trestioreanu, 022328 Bucharest, Romania
- Department of Oncology, Clinical Hospital of Nephrology Dr. Carol Davila, 010731 Bucharest, Romania
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Baltă F, Dinu V, Zemba M, Baltă G, Barac AD, Schmitzer S, Dragosloveanu CDM, Barac RI. Choroidal Thickness Increase after Subliminal Transscleral Cyclophotocoagulation. Diagnostics (Basel) 2022; 12:diagnostics12071513. [PMID: 35885419 PMCID: PMC9316627 DOI: 10.3390/diagnostics12071513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/09/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The purpose of this study is to estimate the success rate of subliminal transscleral cyclophotocoagulation for refractory glaucoma and to determine the correlation between the decrease in intraocular pressure and the variation in choroidal thickness. Methods: A pre−post study was conducted over a period of 3 years, including 81 eyes from 67 patients with different types of drug-refractory glaucoma who underwent subliminal transscleral cyclophotocoagulation. The variables included best-corrected visual acuity, intraocular pressure and choroidal thickness. Results: We observed the following success rates (defined as IOP < 21 mmHg): 80% at 1 month (65 patients), 74% at 3 months (60 patients), 64% at 6 months (52 patients) and 50.6% at 1 year (41 patients). A strong correlation was noted between the decrease in intraocular pressure and the increase in the average choroidal thickness at 1 year (318.42 µm) compared to the average preoperative thickness (291.78 µm). A correlation of increased choroidal thickness at 1-month with the success rate of the procedure was also observed. Conclusions: We observed a statistically significant correlation between the success rate, decrease in intraocular pressure and choroidal thickness. The correlation of increased choroidal thickness at 1-month with the success rate of the procedure could be used clinically as a predictive factor for the final outcome of patients. Further experimental research is warranted to determine whether the increase in choroidal thickness after subliminal transscleral cyclophotocoagulation is indeed evidence of increased uveoscleral drainage.
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Affiliation(s)
- Florian Baltă
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (F.B.); (M.Z.); (A.D.B.); (S.S.); (C.D.M.D.); (R.I.B.)
- Bucharest Emergency Eye Hospital, 030167 Bucharest, Romania;
| | - Valentin Dinu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (F.B.); (M.Z.); (A.D.B.); (S.S.); (C.D.M.D.); (R.I.B.)
- Bucharest Emergency Eye Hospital, 030167 Bucharest, Romania;
- Correspondence: ; Tel.: +40-726195486
| | - Mihail Zemba
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (F.B.); (M.Z.); (A.D.B.); (S.S.); (C.D.M.D.); (R.I.B.)
- Ophthalmology Department, “Dr. Carol Davila” Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - George Baltă
- Bucharest Emergency Eye Hospital, 030167 Bucharest, Romania;
| | - Andreea Diana Barac
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (F.B.); (M.Z.); (A.D.B.); (S.S.); (C.D.M.D.); (R.I.B.)
| | - Speranța Schmitzer
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (F.B.); (M.Z.); (A.D.B.); (S.S.); (C.D.M.D.); (R.I.B.)
- Bucharest Emergency Eye Hospital, 030167 Bucharest, Romania;
| | - Christiana Diana Maria Dragosloveanu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (F.B.); (M.Z.); (A.D.B.); (S.S.); (C.D.M.D.); (R.I.B.)
- Bucharest Emergency Eye Hospital, 030167 Bucharest, Romania;
| | - Ramona Ileana Barac
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (F.B.); (M.Z.); (A.D.B.); (S.S.); (C.D.M.D.); (R.I.B.)
- Bucharest Emergency Eye Hospital, 030167 Bucharest, Romania;
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Dragosloveanu CDM, Zamfiroiu-Avidis N, Dragosloveanu Ş, Păsărică MA, Tătaru CI, Curcă PF. Postoperative retinal microstructure and functional outcome after inverted-flap technique associated with silicone oil tamponade in macular hole surgery. Rom J Morphol Embryol 2022; 62:991-1000. [PMID: 35673818 PMCID: PMC9289692 DOI: 10.47162/rjme.62.4.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Păsărică MA, Curcă PF, Dragosloveanu CDM, Tătaru CI, Manole IR, Murgoi GE, Grigorescu AC. Underlying Ciliary Body Uveal Melanoma in a Patient with Chronic Lymphocytic Leukemia Presenting for Hyphema. Diagnostics (Basel) 2022; 12:diagnostics12061312. [PMID: 35741122 PMCID: PMC9221604 DOI: 10.3390/diagnostics12061312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Background: Ciliary body uveal melanoma is a rare subtype of uveal melanoma which comprises 3–5% of melanomas, an immunogenic cancer, and can present multifaceted initial clinical manifestations, masquerading as various ocular pathologies. Chronic lymphocytic leukemia (CLL) presents immunodeficiency and risk for the development of a secondary malignancy, with Bruton’s tyrosine kinase inhibitor treatment having a mutagenic effect and a secondary anti-platelet aggregation effect. We present the case of a 65-year-old patient undergoing treatment for CLL with ibrutinib who presented with recurrent hyphema that masked an underlying, inferiorly situated, ciliary body uveal melanoma; (2) Methods: Retrospective case review; (3) Results: An ophthalmological examination together with imaging via mode B ultrasound and contrast-enhanced magnetic resonance imaging resulted in the clinical and imagistic diagnosis of a ciliary body uveal melanoma. A pathological examination of the enucleated eye confirmed the diagnosis. Postoperative tumoral reoccurrence was not detected for 1½ years, however, CLL immunosuppression worsened with admission for severe COVID-19 disease. (4) Conclusions: CLL patient screening for melanoma should also include detailed ophthalmological examinations, which could also include ultrasound ophthalmological imaging. The avoidance of uveal melanoma metastatic disease is paramount for patient survival. CLL manifests additional profound immunosuppression.
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Affiliation(s)
- Mihai Adrian Păsărică
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Paul Filip Curcă
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
- Correspondence: ; Tel.: +40-72-015-4452
| | - Christiana Diana Maria Dragosloveanu
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Cătălina Ioana Tătaru
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Ioana Roxana Manole
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Gabriela Elisabeta Murgoi
- Department of Oncology, Institute of Oncology Prof. Dr. Alexandru Trestioreanu, 022328 Bucharest, Romania;
| | - Alexandru Călin Grigorescu
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Oncology, Clinical Hospital of Nephrology Dr. Carol Davila, 010731 Bucharest, Romania
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Potop V, Coviltir V, Schmitzer S, Dragosloveanu CDM, Ionescu CI, Burcel MG, Corbu MC, Dăscălescu DMC. Ultrasound biomicroscopy in glaucoma assessment. Rom J Ophthalmol 2021; 65:114-119. [PMID: 34179574 PMCID: PMC8207866 DOI: 10.22336/rjo.2021.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 12/12/2022] Open
Abstract
Ultrasound biomicroscopy (UBM) is an important tool in the diagnosis, evaluation and follow up of glaucoma patients. Even if we are dealing with a primary angle closure glaucoma (PACG) or a primary open angle glaucoma (POAG) patient, the mechanism of angle closure can be revealed by performing an UBM. The device can help differentiate between the two types of glaucoma even in patients with opaque corneas when gonioscopy cannot be performed. Knowing the type of glaucoma is vital, especially regarding an individualized treatment, since each patient is unique and needs to be treated accordingly, in order to prevent glaucomatous optic neuropathy and visual field loss. Abbreviations: AC = anterior chamber, ICE = iridocorneal endothelial syndrome, IOP = intraocular pressure, NTG = normal tension glaucoma, PACG = primary angle closure glaucoma, PC = posterior chamber, PEX = pseudoexfoliation syndrome, POAG = primary open angle glaucoma, UBM = ultrasound biomicroscopy.
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Affiliation(s)
- Vasile Potop
- Ophthalmology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Ophthalmology Department, Clinical Hospital of Ophthalmologic Emergencies, Bucharest, Romania
| | - Valeria Coviltir
- Ophthalmology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Ophthalmology Department, Clinical Hospital of Ophthalmologic Emergencies, Bucharest, Romania
| | - Speranţa Schmitzer
- Ophthalmology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Ophthalmology Department, Clinical Hospital of Ophthalmologic Emergencies, Bucharest, Romania
| | - Christiana Diana Maria Dragosloveanu
- Ophthalmology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Ophthalmology Department, Clinical Hospital of Ophthalmologic Emergencies, Bucharest, Romania
| | | | | | - Maria Cristina Corbu
- Ophthalmology Department, Clinical Hospital of Ophthalmologic Emergencies, Bucharest, Romania
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Bejinariu CG, Popescu S, Dragosloveanu CDM, Marinescu SA. Reconstruction of lower eyelid defects after the excision of basal cell carcinoma. Rom J Ophthalmol 2020; 64:414-418. [PMID: 33367180 PMCID: PMC7739025 DOI: 10.22336/rjo.2020.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives: The paper presents the reconstructive options of the lower eyelid region in patients who have benefited from the excision of basal cell carcinomas. Methods: The study was based on the clinical and evolutionary particularities analyzed in a series of cases, the patients benefiting from excision and reconstruction for the treatment of basal cell carcinomas located at the level of the orbital region. Results: Following the surgical treatment, the local evolution was favorable with a good functional recovery. The aesthetic results were strongly influenced by the stage of the neoplasm, the final aspect being satisfactory for the patients included in the study. Conclusion: Early diagnosis and rapid and effective surgical treatment are associated with favorable results from a functional and aesthetic point of view. Delayed surgery and treatment of relapses are associated with increased risks and inferior results.
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Affiliation(s)
- Cătălin Gheorghe Bejinariu
- Department of Plastic and Reconstructive Surgery, "Bagdasar-Arseni" Clinical Emergency Hospital, Bucharest, Romania
| | - Siramona Popescu
- Department of Plastic and Reconstructive Surgery, "Bagdasar-Arseni" Clinical Emergency Hospital, Bucharest, Romania
| | | | - Silviu Adrian Marinescu
- Department of Plastic and Reconstructive Surgery, "Bagdasar-Arseni" Clinical Emergency Hospital, Bucharest, Romania
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Bejinariu CG, Dragosloveanu CDM, Marinescu SA. Complex reconstruction of the orbitofrontal regions using three regional flaps after orbital exenteration for the treatment of basal cell carcinoma. Rom J Ophthalmol 2020. [DOI: 10.22336/rjo.2020.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Bejinariu CG, Dragosloveanu CDM, Marinescu SA. Complex reconstruction of the orbitofrontal regions using three regional flaps after orbital exenteration for the treatment of basal cell carcinoma. Rom J Ophthalmol 2020; 64:57-61. [PMID: 32292859 PMCID: PMC7141915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective. The current paper presents an interesting case of facial reconstruction after the excision of a giant basal cell carcinoma located in the orbitofrontal region. Methods. Performing the excision while securing the appropriate oncologic safety margin has determined the appearance of a soft tissue defect that required a complex reconstruction using three regional flaps: frontal, temporal fascial and temporal muscle flaps. Results. After the excision and reconstruction in a single surgical stage, the postoperative result was favorable, the 12 months assessment showing that the patient was satisfied with the aesthetic aspect. Conclusion. Including the orbital exenterations in the excisional treatment of giant neoplasms located in the facial region requires a complex reconstructive plan. The surgical team has to consider the relief of the anatomical structures that are targeted, as well as the necessity of achieving satisfactory aesthetic results while ensuring oncological radicality.
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Affiliation(s)
- Cătălin Gheorghe Bejinariu
- Department of Plastic and Reconstructive Surgery, “Bagdasar-Arseni”
Clinical Emergency Hospital, Bucharest, Romania
| | | | - Silviu Adrian Marinescu
- Department of Plastic and Reconstructive Surgery, “Bagdasar-Arseni”
Clinical Emergency Hospital, Bucharest, Romania
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