title: Classification of orbital exenteration and reconstruction.
abstract: Orbital exenteration (OE) is considered to be a mutilating surgical procedure reserved for relentlessly progressive neoplastic disorders or extensive facial trauma with unfavourable eye involvement. Malignant tumours, accounting for the majority of ablative orbital surgeries, may be caused by primary orbital tumours or secondarily by neoplasias from the surrounding skin, the maxillary sinus or intracranial malignomas. Orbital exenteration following trauma is mostly caused by penetrating globe defects or extended infections with the danger of intracranial effects. Thoughtful resection planning, the exploitation of reconstructive possibilities as well as the consideration of adjuvant therapy are essential to provide the patient with the best available treatment. As a multitude of reconstructive procedures exist, it is of crucial importance to offer a disease-tailored treatment to achieve a successful patient outcome. After retrospective analysis of 45 orbital exenteration cases within the last decade, we developed a defect-driven classification for ablative orbital therapy followed by a guideline for reconstructive procedures. The classification as well as the reconstruction guideline will help the surgeon to restore anatomic boundaries and to promote physiological and psychological recovery for the patient.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: marco.kesting@tum.de.
authors.forename: Marco R
authors.initials: MR
authors.lastname: Kesting
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: steffen.koerdt@tum.de.
authors.forename: Steffen
authors.initials: S
authors.lastname: Koerdt
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: niklas.rommel@tum.de.
authors.forename: Niklas
authors.initials: N
authors.lastname: Rommel
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: thomas.muecke@tum.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mücke
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: klaus-dietrich.wolff@tum.de.
authors.forename: Klaus-Dietrich
authors.initials: KD
authors.lastname: Wolff
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: christopher-nobis@t-online.de.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Nobis
authors.affiliation: Department of Neurosurgery, Universitätsmedizin Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55101 Mainz, Germany. Electronic address: florian.ringel@unimedizin-mainz.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Ringel
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: gesche.frohwitter@mri.tum.de.
authors.forename: Gesche
authors.initials: G
authors.lastname: Frohwitter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D017233:Orbit Evisceration / Q000145:classification*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Free flap; Microsurgery; Orbital exenteration; Reconstructive surgery