Pub Date : 2019-11-01DOI: 10.1097/IOP.0000000000001490
Sara Alshaker, Imran Jivraj, Haiying Chen, P. Muthusami, J. Phillips, D. Deangelis
Congenital hemangiomas comprise a subset of vascular tumors with clinicopathologic features that are distinct from the more common infantile hemangioma. The authors present a patient with a large congenital hemangioma involving the forehead and brow which obstructed the visual axis and created significant risk for deprivational amblyopia. Management of the congenital hemangioma involved customized headgear to clear the visual axis and early vascular embolization of feeder vessels with the subsequent successful surgical resection at 23 days of life.
{"title":"Management of a Large Congenital Hemangioma Obstructing Visual Axis: A Case Report and Review of Literature.","authors":"Sara Alshaker, Imran Jivraj, Haiying Chen, P. Muthusami, J. Phillips, D. Deangelis","doi":"10.1097/IOP.0000000000001490","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001490","url":null,"abstract":"Congenital hemangiomas comprise a subset of vascular tumors with clinicopathologic features that are distinct from the more common infantile hemangioma. The authors present a patient with a large congenital hemangioma involving the forehead and brow which obstructed the visual axis and created significant risk for deprivational amblyopia. Management of the congenital hemangioma involved customized headgear to clear the visual axis and early vascular embolization of feeder vessels with the subsequent successful surgical resection at 23 days of life.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"189 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91467026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/IOP.0000000000001413
Tai M Smith, Shuko Suzuki, Nestor Sabat, Cassie L Rayner, D. Harkin, T. Chirila
PURPOSE A follow-up experimental study on the exposure of animal tarsal plate to ultraviolet-A radiation aimed at establishing an optimum range for safe irradiation conditions. METHODS Sheep tarsus specimens were excised postmortem and then subjected to irradiation with ultraviolet-A rays (wavelength 365 nm) at higher irradiances than those reported in an initial study, using a laboratory radiation source. The mechanical properties (tensile strength and Young's modulus) of irradiated and nonirradiated samples were evaluated in a mechanical tester. The test and control specimens were examined histologically with an aim to assess the effects of radiation upon the meibomian glands and tarsal collagen networks, and to establish a safe range for the exposure irradiance level. RESULTS As expected, irradiation induced both stiffening and strengthening of the tarsal plate specimens. At an irradiance of 50 mW/cm for 3-minute exposure, these effects were at their maximum level, after which a decline in mechanical characteristics were observed. No destruction of the tarsal connective tissue or the meibomian glands were noticed up to an irradiance of 125 mW/cm for 3-minute exposure, corresponding to a fluence of 22.5 J/cm. Histology revealed that the collagen network surrounding the glands were packed more compactly following irradiation. At a fluence of 45 J/cm, massive destruction of periglandular collagen-rich network and meibocytes were demonstrated histologically. CONCLUSIONS The study indicates that irradiation of tarsal collagen leading to tissue stiffening shall be carried out at levels of fluence between 10 and 15 J/cm, a region that is deemed safe. The exposure time can be adjusted according to the surgeon's decision.
{"title":"Further Investigations on the Crosslinking of Tarsal Collagen as a Treatment for Eyelid Laxity: Optimizing the Procedure in Animal Tissue.","authors":"Tai M Smith, Shuko Suzuki, Nestor Sabat, Cassie L Rayner, D. Harkin, T. Chirila","doi":"10.1097/IOP.0000000000001413","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001413","url":null,"abstract":"PURPOSE\u0000A follow-up experimental study on the exposure of animal tarsal plate to ultraviolet-A radiation aimed at establishing an optimum range for safe irradiation conditions.\u0000\u0000\u0000METHODS\u0000Sheep tarsus specimens were excised postmortem and then subjected to irradiation with ultraviolet-A rays (wavelength 365 nm) at higher irradiances than those reported in an initial study, using a laboratory radiation source. The mechanical properties (tensile strength and Young's modulus) of irradiated and nonirradiated samples were evaluated in a mechanical tester. The test and control specimens were examined histologically with an aim to assess the effects of radiation upon the meibomian glands and tarsal collagen networks, and to establish a safe range for the exposure irradiance level.\u0000\u0000\u0000RESULTS\u0000As expected, irradiation induced both stiffening and strengthening of the tarsal plate specimens. At an irradiance of 50 mW/cm for 3-minute exposure, these effects were at their maximum level, after which a decline in mechanical characteristics were observed. No destruction of the tarsal connective tissue or the meibomian glands were noticed up to an irradiance of 125 mW/cm for 3-minute exposure, corresponding to a fluence of 22.5 J/cm. Histology revealed that the collagen network surrounding the glands were packed more compactly following irradiation. At a fluence of 45 J/cm, massive destruction of periglandular collagen-rich network and meibocytes were demonstrated histologically.\u0000\u0000\u0000CONCLUSIONS\u0000The study indicates that irradiation of tarsal collagen leading to tissue stiffening shall be carried out at levels of fluence between 10 and 15 J/cm, a region that is deemed safe. The exposure time can be adjusted according to the surgeon's decision.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81968154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/IOP.0000000000001471
Loka Thangamathesvaran, N. Mirani, R. Turbin, P. Langer
A 58-year-old man presented with a 9-month history of a chronically draining surgical wound and low-grade periorbital inflammation following a right lateral orbitotomy. Imaging of the right orbit revealed a peculiar lesion in the right lateral orbit that was hypointense on both T1- and T2-weighted MRI with peripheral enhancement. Exploratory orbitotomy and biopsy established the diagnosis of a chronic foreign body inflammatory reaction to bone wax; symptoms resolved following evacuation of the retained foreign material.
{"title":"Chronic, Symptomatic Orbital Inflammation Resulting From Retained Bone Wax.","authors":"Loka Thangamathesvaran, N. Mirani, R. Turbin, P. Langer","doi":"10.1097/IOP.0000000000001471","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001471","url":null,"abstract":"A 58-year-old man presented with a 9-month history of a chronically draining surgical wound and low-grade periorbital inflammation following a right lateral orbitotomy. Imaging of the right orbit revealed a peculiar lesion in the right lateral orbit that was hypointense on both T1- and T2-weighted MRI with peripheral enhancement. Exploratory orbitotomy and biopsy established the diagnosis of a chronic foreign body inflammatory reaction to bone wax; symptoms resolved following evacuation of the retained foreign material.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78960589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/IOP.0000000000001475
Juliana R Gildener-Leapman, R. Stein, Iyar Sheps, O. Benyamini, A. Milstein, M. Hartstein
{"title":"Reply re: \"The Sutureless Mullerectomy\".","authors":"Juliana R Gildener-Leapman, R. Stein, Iyar Sheps, O. Benyamini, A. Milstein, M. Hartstein","doi":"10.1097/IOP.0000000000001475","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001475","url":null,"abstract":"","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84560731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/IOP.0000000000001465
Eric B. Desjarlais, N. Jovanovic, H. M. Teo, A. Kahana
The development of orbit-eroding mucocele associated with inverted papilloma has been rarely reported. Here, the authors present a case and surgical management of a patient with orbit-eroding mucocele associated with inverted papilloma who declined craniotomy. A combined approach utilizing frontal endoscopic sinus surgery and external sub-brow anterior orbitotomy was used to explore, drain, and excise the mucocele and inverted papilloma. Gelatin sponges soaked in gentamicin were used to cover the exposed dura and to protect the orbital content from the frontal sinus cavity.
{"title":"Surgical Management of a Recurrent Orbit-Eroding Mucocele Associated With Frontal-Ethmoidal Sinus Inverted Papilloma.","authors":"Eric B. Desjarlais, N. Jovanovic, H. M. Teo, A. Kahana","doi":"10.1097/IOP.0000000000001465","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001465","url":null,"abstract":"The development of orbit-eroding mucocele associated with inverted papilloma has been rarely reported. Here, the authors present a case and surgical management of a patient with orbit-eroding mucocele associated with inverted papilloma who declined craniotomy. A combined approach utilizing frontal endoscopic sinus surgery and external sub-brow anterior orbitotomy was used to explore, drain, and excise the mucocele and inverted papilloma. Gelatin sponges soaked in gentamicin were used to cover the exposed dura and to protect the orbital content from the frontal sinus cavity.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78077740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/IOP.0000000000001474
N. Homer, A. Huggins, Tanuj Nakra
To the Editor: We are grateful to Drs. Homer, Huggins, and Nakra for their letter discussing our paper on Sutureless Mullerectomy. Dr. Homer et al. point out several criticisms which we would like to address. We agree that the efficacy of the sutureless Müller's muscleconjunctival resection would be better demonstrated in a series of ptosis patients without concurrent blepharoplasty. However, the reality is that most patients undergoing ptosis repair can also benefit from blepharoplasty, if for no other reason than to address the redundant skin created by the ptosis repair. Dr. Homer cites their own study that blepharoplasty alone is responsible for a 0.7 mm improvement in upper lid height. This may be an important finding. However, the sample size was small (19 patients), had a relatively short follow-up, and had its own confounder that about half the patients underwent concurrent lower blepharoplasty. A more recent study demonstrated only 0.19 mm improvement in lid height after blepharoplasty in a much larger cohort. And this improvement in lid height is generous when compared to results of other studies found in the literature. Homer et al. themselves cite such articles that demonstrate minimal or no improvement in lid height after blepharoplasty. Thus, their own study can hardly be considered a gold standard. Dr. Homer presumes that our technique was based on the report of sutureless Fasanella. While we acknowledged the potential corroboration of our technique with that of the sutureless Fasanella, we emphasize that the inspiration for our study came from our observation of the exuberant re-adherence of the tissues after recession for overcorrected Müller's muscleconjunctival resection as well as from the success of Müller's muscleconjunctival resection with fibrin glue. To the Editor: The authors read with interest Gildener-Leapman et al.’s article on sutureless mullerectomy. Gildener-Leapman et al. describe a modification to the traditional Putterman clampassisted mullerectomy, in which the isolated Müllers muscleconjunctival tissue is clamped, excised, and cauterized, without use of sutures. They report an average 1.4 mm improvement in MRD1 in 19 patients who underwent this procedure. The authors are enthusiastic about the practical evolution of oculoplastic procedures; however, the authors have several critiques of Gildener-Leapman et al.’s research methodology and surgical technique. First, the authors question the validity of the reported upper eyelid height improvement in the study. Previous reports have found an average margin reflex distance 1 (MRD1) improvement of 1.3–3.26 mm with the traditional mullerectomy. The authors have previously reported an average 0.7 mm MRD1 improvement with upper blepharoplasty alone. The authors noted that 15 of Gildener-Leapman et al.’s 19 patients in the current study underwent concurrent upper blepharoplasty. The lessons of the authors’ study suggest that a majority of GildenerLeapman et al.’s patien
{"title":"Re: \"The Sutureless Mullerectomy\".","authors":"N. Homer, A. Huggins, Tanuj Nakra","doi":"10.1097/IOP.0000000000001474","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001474","url":null,"abstract":"To the Editor: We are grateful to Drs. Homer, Huggins, and Nakra for their letter discussing our paper on Sutureless Mullerectomy. Dr. Homer et al. point out several criticisms which we would like to address. We agree that the efficacy of the sutureless Müller's muscleconjunctival resection would be better demonstrated in a series of ptosis patients without concurrent blepharoplasty. However, the reality is that most patients undergoing ptosis repair can also benefit from blepharoplasty, if for no other reason than to address the redundant skin created by the ptosis repair. Dr. Homer cites their own study that blepharoplasty alone is responsible for a 0.7 mm improvement in upper lid height. This may be an important finding. However, the sample size was small (19 patients), had a relatively short follow-up, and had its own confounder that about half the patients underwent concurrent lower blepharoplasty. A more recent study demonstrated only 0.19 mm improvement in lid height after blepharoplasty in a much larger cohort. And this improvement in lid height is generous when compared to results of other studies found in the literature. Homer et al. themselves cite such articles that demonstrate minimal or no improvement in lid height after blepharoplasty. Thus, their own study can hardly be considered a gold standard. Dr. Homer presumes that our technique was based on the report of sutureless Fasanella. While we acknowledged the potential corroboration of our technique with that of the sutureless Fasanella, we emphasize that the inspiration for our study came from our observation of the exuberant re-adherence of the tissues after recession for overcorrected Müller's muscleconjunctival resection as well as from the success of Müller's muscleconjunctival resection with fibrin glue. To the Editor: The authors read with interest Gildener-Leapman et al.’s article on sutureless mullerectomy. Gildener-Leapman et al. describe a modification to the traditional Putterman clampassisted mullerectomy, in which the isolated Müllers muscleconjunctival tissue is clamped, excised, and cauterized, without use of sutures. They report an average 1.4 mm improvement in MRD1 in 19 patients who underwent this procedure. The authors are enthusiastic about the practical evolution of oculoplastic procedures; however, the authors have several critiques of Gildener-Leapman et al.’s research methodology and surgical technique. First, the authors question the validity of the reported upper eyelid height improvement in the study. Previous reports have found an average margin reflex distance 1 (MRD1) improvement of 1.3–3.26 mm with the traditional mullerectomy. The authors have previously reported an average 0.7 mm MRD1 improvement with upper blepharoplasty alone. The authors noted that 15 of Gildener-Leapman et al.’s 19 patients in the current study underwent concurrent upper blepharoplasty. The lessons of the authors’ study suggest that a majority of GildenerLeapman et al.’s patien","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73418204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/IOP.0000000000001455
David S. Curragh, Rowan J. Valentine, D. Selva
Cerebrospinal fluid leaks are rarely encountered by orbital surgeons, but can occur during dacryocystorhinostomy, orbital decompression, orbital exenteration, and enucleation. The authors present a case of cerebrospinal fluid leak from an injury to the orbital roof during orbital exenteration with the use of monopolar cautery. This was repaired with multilayer closure. Surgeons performing orbital exenteration must be aware of the possibility of this complication when using monopolar electrocautery to transect the orbital contents at the apex during an exenteration.
{"title":"Cerebrospinal Fluid Leak From the Orbital Roof During Orbital Exenteration.","authors":"David S. Curragh, Rowan J. Valentine, D. Selva","doi":"10.1097/IOP.0000000000001455","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001455","url":null,"abstract":"Cerebrospinal fluid leaks are rarely encountered by orbital surgeons, but can occur during dacryocystorhinostomy, orbital decompression, orbital exenteration, and enucleation. The authors present a case of cerebrospinal fluid leak from an injury to the orbital roof during orbital exenteration with the use of monopolar cautery. This was repaired with multilayer closure. Surgeons performing orbital exenteration must be aware of the possibility of this complication when using monopolar electrocautery to transect the orbital contents at the apex during an exenteration.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90734679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/iop.0000000000001488
T. Janetos, P. Thyparampil
{"title":"Reply re: \"Ocular Cosmetics: Public Safety Problem or Harmless Products?\"","authors":"T. Janetos, P. Thyparampil","doi":"10.1097/iop.0000000000001488","DOIUrl":"https://doi.org/10.1097/iop.0000000000001488","url":null,"abstract":"","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82222482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/IOP.0000000000001460
A. Rider, Anna Walsh, E. Sollenberger, S. Dryden, Kendra D DeAngelis, A. Weir, B. Fowler
Two patients with previously diagnosed pheochromocytoma presented with facial pain and ptosis. Imaging revealed orbital lesions. Both patients were referred for surgical evaluation of the orbital mass. Surgical excision was performed for both. Pathology confirmed metastatic pheochromocytoma. Pheochromocytomas commonly metastasize to bone, liver, and other tissues. Five cases of metastasis to orbital bone have been previously described. These 2 cases are unique in that the metastases were not hormonally active, presented soon after initial diagnosis, and were treated palliatively with surgical excision. Previous treatment of orbital bony metastasis used radiotherapy. These cases demonstrate that surgical resection is a viable treatment option in these situations. Orbital metastasis of pheochromocytomas should be considered with the appropriate clinical presentation. These are the first documented cases of intraorbital metastasis, separate from the bony walls. Previously, orbital bony wall metastases were treated with radiation. Surgical excision is a viable option for treatment of such metastases.
{"title":"Orbital Pheochromocytoma Metastasis in 2 Patients With Known Pheochromocytoma.","authors":"A. Rider, Anna Walsh, E. Sollenberger, S. Dryden, Kendra D DeAngelis, A. Weir, B. Fowler","doi":"10.1097/IOP.0000000000001460","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001460","url":null,"abstract":"Two patients with previously diagnosed pheochromocytoma presented with facial pain and ptosis. Imaging revealed orbital lesions. Both patients were referred for surgical evaluation of the orbital mass. Surgical excision was performed for both. Pathology confirmed metastatic pheochromocytoma. Pheochromocytomas commonly metastasize to bone, liver, and other tissues. Five cases of metastasis to orbital bone have been previously described. These 2 cases are unique in that the metastases were not hormonally active, presented soon after initial diagnosis, and were treated palliatively with surgical excision. Previous treatment of orbital bony metastasis used radiotherapy. These cases demonstrate that surgical resection is a viable treatment option in these situations. Orbital metastasis of pheochromocytomas should be considered with the appropriate clinical presentation. These are the first documented cases of intraorbital metastasis, separate from the bony walls. Previously, orbital bony wall metastases were treated with radiation. Surgical excision is a viable option for treatment of such metastases.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88484949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.1097/IOP.0000000000001468
K. Ullrich, B. Bisase, Siva Kumar, R. Malhotra
Electrochemotherapy has been used successfully for treatment of recurrent head and neck skin cancers and skin metastasis. It combines both electroporation and chemotherapy. The authors report 4 patients, who all had metastatic periorbital malignancy. These patients were palliative with widespread metastatic malignancy. All patients had either already had multiple procedures or declined surgical resection and preferred less involved measures. The authors report technique and outcomes. Patient 1: 83-year-old man with recurrent malignant melanoma (MM) nodules (BRAF negative) in the left medial orbit and medial canthal area after rhinectomy and previous resections. Patient 2: 72-year-old man with metastatic MM who developed painful and unsightly metastatic nodules on the right and left forehead and the left medial canthus. Patient 3: 93-year-old man with background of widespread multiple myeloma, considered palliative. He developed a left forehead SCC, apparent as a fungating ulcer, which caused significant pain due to perineural invasion. Patient 4: 91-year-old woman with recurrent metastatic sebaceous cell carcinoma of the left lower eyelid obstructing her vision. All patients experienced an improvement in their pain and quality of life. None of the patients developed any significant periorbital inflammation or adverse complications. Electrochemotherapy may be a useful palliative treatment for periorbital tumors. It improves pain and reduces tumor volume. It can be considered for tumors where palliative radiotherapy may be contraindicated.
{"title":"Maintaining Quality of Life: Electrochemotherapy for Palliative Periorbital Malignancy.","authors":"K. Ullrich, B. Bisase, Siva Kumar, R. Malhotra","doi":"10.1097/IOP.0000000000001468","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001468","url":null,"abstract":"Electrochemotherapy has been used successfully for treatment of recurrent head and neck skin cancers and skin metastasis. It combines both electroporation and chemotherapy. The authors report 4 patients, who all had metastatic periorbital malignancy. These patients were palliative with widespread metastatic malignancy. All patients had either already had multiple procedures or declined surgical resection and preferred less involved measures. The authors report technique and outcomes. Patient 1: 83-year-old man with recurrent malignant melanoma (MM) nodules (BRAF negative) in the left medial orbit and medial canthal area after rhinectomy and previous resections. Patient 2: 72-year-old man with metastatic MM who developed painful and unsightly metastatic nodules on the right and left forehead and the left medial canthus. Patient 3: 93-year-old man with background of widespread multiple myeloma, considered palliative. He developed a left forehead SCC, apparent as a fungating ulcer, which caused significant pain due to perineural invasion. Patient 4: 91-year-old woman with recurrent metastatic sebaceous cell carcinoma of the left lower eyelid obstructing her vision. All patients experienced an improvement in their pain and quality of life. None of the patients developed any significant periorbital inflammation or adverse complications. Electrochemotherapy may be a useful palliative treatment for periorbital tumors. It improves pain and reduces tumor volume. It can be considered for tumors where palliative radiotherapy may be contraindicated.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80878301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：