Orbital Extenteration Defects: Ablative and Reconstructive Flowchart Proposal : Journal of Craniofacial Surgery

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Orbital Extenteration Defects: Ablative and Reconstructive Flowchart Proposal

Mannelli, Giuditta MD, PhD*; Comini, Lara V. MD; Marzola, Antonio PhD; Volpe, Yari PhD; Mazzini, Cinzia MD§; Santoro, Nicola MD, PhD§; Delcroix, Luca MD; Molteni, Gabriele MD, PhD; Spinelli, Giuseppe MD#

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The Journal of Craniofacial Surgery 34(3):p 893-898, May 2023. | DOI: 10.1097/SCS.0000000000009052


Orbital exenteration is a radical and disfiguring operation. It is still under debate the absence of correlation between the term describing the resulting orbital defect and the type of reconstruction. Authors’ goal was to propose a consistent and uniform terminology for Orbital Exenteration surgery in anticipation of patients’ tailored management. Twenty-five patients who underwent orbital exenteration between 2014 and 2020 were reviewed. A parallel comprehensive literature review was carried on. Five different types of orbital exenteration where outlined. Multiple reconstructive procedures were enclosed. An algorithm for orbital reconstruction was proposed based on anatomic boundaries restoration. Eyelid removal was first considered as an independent reconstructive factor, and both orbital roof and floor were indicated as independent reconstructive goals, which deserve different defect classification. In our opinion, this algorithm could be a useful tool for patient counseling and treatment selection, which might allow a more tailored patient care protocol.

Level of Evidence 

Level III.

Copyright © 2022 by Mutaz B. Habal, MD

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