Exenteración orbitaria: experiencia de seis años / Orbital exenteration: six years of experience

Objetivo: describir las características clínico-patológicas y los resultados obtenidos en pacientes sometidos a exenteración orbitaria. Métodos: se realizó un estudio descriptivo, retrospectivo, de serie de casos, en el Instituto de Oncología y Radiobiología, desde enero del año 2011 a diciembre de 2016. La muestra se conformó con 71 pacientes exenterados y fue caracterizada según la edad, el sexo, el origen de la lesión, el diagnóstico histopatológico, los tratamientos previos, el tipo de exenteración orbitaria, el estado de los bordes de la sección quirúrgica, los tratamientos adyuvantes, los abordajes quirúrgicos asociados, la reconstrucción de la cavidad y las complicaciones posoperatorias. Resultados: el 67,6 por ciento de la muestra estudiada fue del sexo masculino. El 43,7 por ciento se encontró en el grupo de 60 a 79 años de edad; en el 38 por ciento de los pacientes la lesión primaria estuvo localizada en los párpados y en el 56,3 por ciento el diagnóstico histopatológico fue el carcinoma epidermoide. El 100 por ciento de la muestra había recibido algún tipo de tratamiento médico previo. Al 69 por ciento de la muestra se le realizó exenteración orbitaria tipo III, y solo en el 15,5 por ciento se reportaron bordes de la sección quirúrgica positivos. El 29,6 por ciento recibió tratamiento adyuvante con radioterapia. Se necesitó la combinación con otros abordajes quirúrgicos en el 28,2 por ciento de los pacientes y en el 69 por ciento se permitió la cicatrización espontánea de la cavidad orbitaria. La fístula senorbital fue la complicación más frecuente, con el 8,5 por ciento. Conclusiones: el carcinoma epidermoide es el tumor periocular que con mayor frecuencia invade la órbita. En la mayoría de los casos exenterados se logra la resección total del tumor con complicaciones posoperatorias mínimas(AU)

Objective: to describe the clinical and pathological characteristics and the results obtained in patients undergoing orbital exenteration. Methods: a descriptive, case series and retrospective study was carried out at the Institute of Oncology and Radiobiology from January 2011 to December 2016. The sample of 71 exenterated patients was characterized according to age, sex, origin of the lesion, histopathological diagnosis, previous treatments, type of orbital exenteration, state of the surgical section edges, adjuvant treatments, associated surgical approaches, reconstruction of the cavity and postoperative complications. Results: in this sample, 67.6 percent of the studied sample were men, 43.7 % were in the 60-79 age group; the primary lesion of 38 percent was located in the eyelids and and the histopathological diagnosis in 56.3 percent of patients was squamous cell carcinoma. One hundred percent of the sample had received some type of previous medical treatment, 69 percent of the sample underwent type III orbital exenteration, and only in 15.5 percent, the surgical section edges were reported as positive. Also, 29.6 percent received adjuvant treatment with radiotherapy. The combination with other surgical approaches was required in 28.2 percent of patients and percent spontaneous healing of the orbital cavity was allowed in 69 percent. The sino-orbital fistula was the most frequent complication (8.5 percent). Conclusions: squamous cell carcinoma is the periocular tumor that most frequently invades the orbit. Most exenterated cases managed to achieve total resection of the tumor with minimal postoperative complications(AU)

Determination of oral microflora in irradiated ocular deformed children.

Children with a retinoblastoma usually have enucleation of eye contents and undergo radiation therapy. In this group of children a slight deformation in facial growth is exhibited on the operated side. The radiation affects the oral microflora. This study was conducted to investigate the oral microflora in this group of patients compared to normal children. Nineteen children, ages 4-15 years, were tested for oral microflora by culture. A control group was comprised of 20 normal healthy children from a primary school in Bangkok, Thailand. Paraffin-stimulated whole saliva was collected and cultured for the presence of mutans streptococci, lactobacilli and Candida species. The isolation frequencies and abundances of lactobacilli and Candida species in saliva samples of irradiated children were significantly greater than healthy children. The mutans streptococci counts were significantly different from healthy controls. Radiation therapy may have had some influence on the oral ecology of these patients, so had a higher risk of caries and candidiasis than the healthy controls. Therefore, comprehensive preventive measures should be taken in these children.

Intracerebral hemorrhage following enucleation: a result of surgery or anesthesia ? A Case Report

Choroidal melanoma is the most common primary intraocular cancer in adults. A sixty-nine years old, hypertensive male with a choroidal melanoma underwent enucleation. After extubation he woke up confused and unconscious. An emergent computed tomographic [CT] scan demonstrated intracerebral hematoma. The underwent repeat surgery in the postoperative first hour, because of left parietotemporal intracerebral hematoma. His neurological state became worse and he died in the eighth postoperative day. Sympathetic stimulation due to extubation, causing increase in the intracranial pressure or uncontrolled hypertension, may be reasons precipitating intracranial hemorrhage. In patients, who undergo intracranial or intraorbital surgery, had risk factors of intracranial hemorrhage or showed labile blood pressure perioperatively and were confused or unconscious in the postoperatively or had delayed emergence, intracranial hematoma must be suspected

Evisceration, enucleation, and exentration: painful but life saving surgical procedures

To determine the indications for Evisceration, Enucleation and Exentration in patients operated at the eye department. It was a prospective study done at Khyber Teaching Hospital, Peshawar, from May 2001 to October 2003. A total of 110 cases comprising of 50 enucleations, 34 evisceration, and 26 exentration were seen. Ocular malignancy was the commonest cause for eneucleation while postoperative panophthalmitis and trauma were the reasons for evisceration and for exentration the indication was squamous cell carcinoma involving lid and conjunctiva followed by basal cell carcinoma. Only a minority of cases of eye globe surgery are preventable and/or treatable, while rest are due to malignancy. Early diagnosis in these cases is likely to make surgery easy with promising postoperative cure

Enucleaçäo ocular em crianças no Hospital Univeersitário Prof. Edgard santos / Ocular enucleation in children

Os autores estudaram 52 olhos enucleados em crianças de zero a doze anos, em um período de dez anos. Todos os olhos foram submetidos a estudo histopatológico. Nesta série, o retinoblastoma foi a principal causa isolada de enucleaçäo, sendo notada ainda uma queda na incidência de realizaçäo deste tipo de cirurgia com o avançar da faixa etária

Oftalmia simpática; apresentaçäo de um caso / Sympathetic ophthalmia

As autoras apresentam um caso de oftalmia simpática em paciente, após ferimento no olho. O diagnóstico foi confirmado por exame anátomo-patológico após enucleaçäo

Prevençäo das deformidades órbito-palpebrais das cavidades anoftámicas; 20 anos de experiência / Prevention of orbitopalpebral deformities in anophthalmic cavities. A 20 years experience

A experiência de 20 anos na prevençäo de defeitos estéticos e outras deformaçöes observadas após eviscerçöes e enucleaçöes, levou o autor a utilizar esferas de acrílico revestidas de esclera preservada, supultando-as na cápsula de Tenon e fixadas aos músculos. Preferencialmente, é aconselhada a evisceraçäo. Mais de 95// dos casos operados trouxeram excelentes resultados cosméticos e com boa motibilidade das próteses. Foram poucas as extrusöes