Retrospective analysis of histopathological diagnosis of orbital exenterations: Single center, 10 years experience

Abstract

Aim: Aim of this study is to analyze the histopathological diagnosis of orbital exenterations performed during the study period.

Material and Methods: Orbital exenterations performed between 1 January 2009 and 31 December 2018 at Cukurova University Faculty of Medicine Department of Plastic Reconstructive and Aesthetic Surgery have been analysed. Data was obtained retrospectively  by reveiwing operation log books and medical records. Age, sex, operated eye (left or right), histopathological diagnosis obtained from exenteration material, surgical margins, type of exenteration, reconstruction method and surgical area complications were recorded.

Results: 47 orbital exenteration operations have been performed during the study period.

7 case records were irretrievable. 40 were analyzed. The male to female ratio was 1:1 and average (min-max) age was 61.5 (4-86). Exenteration was performed because of squamous cell carcinoma at 17 (42.5 %), basal cell carcinoma at10 (25 %), basosquamous carcinoma at 3 (7,5 %), retinoblastoma at 3 (7,5 %), malign melanoma at 2 (5 %) and  at 5 patients for other malignancies (carcinoma insitu, rhabdomyosarcoma, ameloblastic carcinoma, malignant peripheral nerve sheath tumor, adenocarcinoma).

Conclusion : Most common malignancies resulting orbital exenteration are squamous cell and basal cell carcinomas and early and effective treatment methods can limit indications for orbital exenterations.

Keywords

• orbit,exenteration,squamous cell carcinoma,basal cell carcinoma

Orbital ekzenterasyon olgularının histopatolojik tanılarının retrospektif analizi: Tek merkez, 10 yıllık tecrübe

Öz

Amaç: Bu makalenin amacı çalışma döneminde gerçekleştirilen orbital ekzenterasyon vakalarının histopatolojik tanılarının analiz edilmesidir.

Materyal ve Metod: Bu retrospektif çalışmada Çukurova Üniversitesi Tıp Fakültesi Plastik Rekonstrüktif ve Estetik Cerrrahi Kliniği (Adana/ Türkiye)’nde 1 Ocak 2009- 31 Aralık 2018  tarihleri arasında gerçekleştirilen orbital ekzenterasyon vakaları analiz edilmiştir. Veriler ameliyat kayıt defterleri taranarak ve hasta dosyaları incelenerek elde edilmiştir. Yaş, cinsiyet, hangi göze ekzenterasyon uygulandığı, ekzenterasyon materyalinin patoloji raporundan elde edilen histopatolojik tanı, cerrahi sınır, ekzenterasyon tipi, onarım yöntemi ve yara yeri komplikasyonları değerlendirilmiştir.

Bulgular:  Çalışma döneminde 47 orbital ekzenterasyon operasyonu gerçekleştirilmiştir. 7 hastanın verilerine ulaşılamadığı için çalışmaya dahil edilmemiştir. Çalışmaya 40 hasta dahil edilmiştir. Kadın / erkek oranının 1/1 ve ortalama (min-maks) yaşın 61,5 (4-86) olduğu görülmüştür.  Hastaların 17  (%42,5) tanesi yassı hücreli karsinom, 10 (%25)tanesi  bazal hücreli karsinom, 3 (%7,5) tanesi bazoskuamöz hücreli karsinom, 3 (%7,5) tanesi retinablastom, 2 tanesi (%5,0) malign melanom ve 5 tanesi diğer nedenlerle (karsinoma insitu, rabdomiyosarkom, ameloblastik karsinom, malign sinir kılıfı tümörü, adenokarsinom) opere edilmiştir.

Sonuç: Orbital ekzenterasyonların en sık nedeni yassı hücreli ve bazal hücreli karsinomdur  ve etkili erken tedavi yöntemleri ile ekzenterasyon ihtiyacı kısıtlanabilir

Anahtar Kelimeler

• orbita,ekzenterasyon,yassı hücreli karsinom,bazal hücreli karsinom

Kaynakça

1. Brecht LE. Craniofacial and maxillofacial prosthetics. In: Grabb and Smith’s plastic surgery. 6th edn. Philadelphia: Lippincott Williams & Wilkins.2007:350-352.
2. Nabavi CB, Czyz CN. Orbit: Orbital Exenteration (Subtotal/Total/Extended). In: Operative Dictations in Ophthalmology. Springer; 2017:433-436.
3. Soysal HG. Orbital exenteration: a 10-year experience of a general oncology hospital. Orbit. 2010;29(3):135-139.
4. Duman R, Balci M, DUMAN R, Ozdogan S. Orbital exenterations: our experience at ankara oncology research and training hospital. International Journal of Hematology and Oncology. 2013;28(4):166-170.
5. Kiratli H, Koç İ. Orbital exenteration: Institutional review of evolving trends in indications and rehabilitation techniques. Orbit. 2018;37(3):179-186.
6. Gunalp I, Gunduz K, Duruk K. Orbital exenteration: a review of 429 cases. International ophthalmology. 1995;19(3):177-184.
7. Ackuaku-Dogbe E. Review of orbital exenterations in Korle-Bu teaching hospital. Ghana medical journal. 2011;45(2):45-49.
8. Bartley GB, Garrity JA, Waller RR, Henderson JW, Ilstrup DM. Orbital exenteration at the Mayo Clinic. 1967-1986. Ophthalmology. 1989;96(4):468-473.

9. Levin PS, Ellis DS, Stewart WB, Toth BA. Orbital exenteration. The reconstructive ladder. Ophthalmic plastic and reconstructive surgery. 1991;7(2):84-92.
10. Mohr C, Esser J. Orbital exenteration: surgical and reconstructive strategies. Graefe's archive for clinical and experimental ophthalmology. 1997;235(5):288-295.
11. Rahman I, Cook A, Leatherbarrow B. Orbital exenteration: a 13 year Manchester experience. British Journal of Ophthalmology. 2005;89(10):1335-1340.
12. Rathbun JE, Beard C, Quickert MH. Evaluation of 48 cases of orbital exenteration. American journal of ophthalmology. 1971;72(1):191-199.
13. Al-Hity A, Gregory ME, Kemp EG. The intraoperative use of polydioxanone foil to reduce the risk of sino-orbital fistula formation in orbital exenteration. Orbit. 2018;37(2):140-144.
14. Hararah MK, Mattingly JK, Ramakrishnan VR. Use of a Contralateral Nasoseptal Flap for Sino-Orbital Fistula Closure. The Journal of craniofacial surgery. 2018;29(3):709-711.