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内镜辅助眼眶内容剜除术:单中心连续病例系列的技术可行性及手术结果

Endoscopic-assisted orbital exenteration: Technical feasibility and surgical results from a single-center consecutive series.

作者信息

Turri-Zanoni Mario, Arosio Alberto Daniele, Agosti Edoardo, Battaglia Paolo, Cherubino Mario, Balbi Sergio, Margherini Stefano, Locatelli Davide, Valdatta Luigi, Castelnuovo Paolo

机构信息

Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy; Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.

Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.

出版信息

J Craniomaxillofac Surg. 2022 Feb;50(2):156-162. doi: 10.1016/j.jcms.2021.11.005. Epub 2021 Nov 26.

Abstract

The purposes of this study were to describe the endoscopic-assisted orbital exenteration surgical techniques, to report preliminary outcomes and to discuss advantages, indications and limitations of this approach. All patients who underwent endoscopic-assisted orbital exenteration at a single tertiary-care center were retrospectively reviewed. A concomitant reconstruction was performed in all cases. The extent of surgical resection was tailored to the size and location of tumor and was classified into four subtypes. A total of 40 patients were included in this series. Orbital exenteration type 1 was performed in 7 cases, type 2 in 11 cases, type 3 in 19 cases, and type 4 in 3 cases. The reconstruction was performed with a pedicled temporal flap in 5 patients and with a free vascularized flap in 34 cases. A radical resection of disease was obtained in 32 cases. After a mean follow-up of 36 months, 14 patients died of disease, one patient died of other causes, 7 are alive with disease, and 18 patients are currently alive without evidence of disease. The preliminary data emerging from this case-series support the feasibility and safety of endoscopic-assisted orbital exenteration.

摘要

本研究的目的是描述内镜辅助眼眶内容剜除术的手术技术,报告初步结果,并讨论该方法的优点、适应证和局限性。对在一家三级医疗中心接受内镜辅助眼眶内容剜除术的所有患者进行回顾性研究。所有病例均进行了同期重建。手术切除范围根据肿瘤的大小和位置进行调整,分为四种亚型。本系列共纳入40例患者。1型眼眶内容剜除术7例,2型11例,3型19例,4型3例。5例患者采用带蒂颞叶皮瓣重建,34例采用游离血管化皮瓣重建。32例患者实现了疾病的根治性切除。平均随访36个月后,14例患者死于疾病,1例患者死于其他原因,7例患者带瘤生存,18例患者目前存活且无疾病证据。该病例系列得出的初步数据支持内镜辅助眼眶内容剜除术的可行性和安全性。

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