ORBITAL EXENTERATION - A REVIEW OF 429 CASES

The authors reviewed their experience with 429 cases of orbital exente ration between 1963 and 1993. Apart from the 22 cases operated in conc ert with other physicians, 407 cases were operated by an ophthalmologi st and spontaneous granulation technique was used. Total or eyelid-sac rificing exenteration was carried out for lesions involving the eyelid s and for recurrent/infiltrative malignant tumors. Two hundred and thi rty-seven cases received total exenteration. The remaining 192 cases w ere treated with eyelid-sparing or subtotal exenteration. In each case , full exenteration was performed with the removal of the periosteum. Secondary tumors were the most frequent indication for exenterations a ccounting for 349 (81.3%) cases. Among the secondary tumors, there wer e 173 eyelid, 104 intraocular, 56 conjunctival tumors, 15 nasopharynx and one maxillary sinus carcinomas. The second leading indication was primary orbital tumors (50 cases, 11.7%). Of the primary orbital tumor s, 35 were rhabdomyosarcomas, nine were neurogenic tumors, two were fi brocytic tumors, two were vascular tumors, one was teratoma and one wa s primary melanocytic tumor. The remaining cases included 16 lacrimal fossa tumors (3.7%), 10 lymphomas (2.3%) and four (1.0%) inflammatory pseudotumors. Squamous cell carcinoma was the single most frequent ind ication for which exenteration was carried out, accounting for 30.3% o f the cases. Spontaneous granulation proved to be a simple technique a nd produces cosmetically better results for patients not wearing prost hesis.