Ophthalmological outcome after orbital entry during anterior and anterolateral skull base surgery.
OBJECTIVE
Partial resection of the orbital bones is not uncommon during the excision of anterior and anterolateral skull base tumors. Controversy exists regarding the need for and extent of reconstruction after this procedure. The authors studied this factor in a series of patients.


METHODS
The authors conducted a retrospective review of 56 patients in whom resection of 57 anterior or anterolateral skull base tumors and partial excision of the orbital bone were performed. Adverse ophthalmological outcomes were noted in 16 patients, in nine of whom adverse outcomes were believed to be directly related to resection of the orbital walls. Some degree of orbital reconstruction was performed during 23 of the 57 procedures. An adverse orbital outcome was strongly associated with resection of the orbital floor and resection of two thirds or more of two or more orbital walls, but not with the presence or absence of orbital reconstruction. The later finding, however, is likely a function of selection bias.


CONCLUSIONS
In most patients elaborate orbital reconstruction is not necessary after partial excision of the orbital bones. Isolated medial and lateral orbital wall defects, or combined superior and lateral orbital wall defects, especially in cases in which the periorbita is intact, probably do not require primary reconstruction. In cases of orbital floor defects, whether isolated or part of a multiple-wall resection, primary reconstruction is recommended.
DeMonte
Franco
F
Department of Neurosurgery, M. D. Anderson Cancer Center, Houston, Texas 77030, USA. fdemonte@mdanderson.org
Tabrizi
Peyman
P
Culpepper
Scott A
SA
Suki
Dima
D
Soparkar
Charles N S
CN
Patrinely
James R
JR
D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D009915:Orbit / Q000033:anatomy & histology / Q000601:surgery*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D019291:Skull Base / Q000033:anatomy & histology / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome