AIM: An en bloc orbitectomy is one of the most invasive surgical procedures in the orbit, primarily used to remove advanced malignancies, ensure negative resection margins, and local cancer control. This study examines the indications, clinical features, outcomes, and survival rates of patients who underwent this surgery for periocular and orbital malignancies. PATIENTS AND METHODS: A retrospective consecutive case series of seven patients with various orbital carcinomas managed with en bloc orbitectomy from 2018-2023 at the University Hospital in Pilsen, Czech Republic, was conducted. Minor surgeries and other diagnoses were excluded. RESULTS: The study included seven patients, with an average age of 68.7 years (range 50-83, median 74). Orbitectomy was part of salvage surgery in two patients and debulking in one. R0 resection was achieved in only 50% of cases; defects were reconstructed with a free anterolateral thigh (ALT) flap in one case and local flaps in others. Therapeutic neck dissection was performed in three patients directly after surgery, in one case 15 months after orbitectomy. CONCLUSION: A thorough examination of indications, patient and tumor features, and reconstructive possibilities should precede an en bloc orbitectomy. Despite being highly invasive, it should be adequately indicated to avoid less invasive surgeries that could complicate radical surgery and impair disease control.
- Publikační typ
- časopisecké články MeSH
- MeSH
- lidé MeSH
- zubní kliniky * dějiny organizace a řízení MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
The use of antiangiogenic and antiresorptive medications, particularly in patients with cancer or osteoporosis, can lead to osteonecrosis of the jaw following tooth extraction, trauma or arising spontaneously- A condition known as medication-related osteonecrosis of the jaw (MRONJ). In this article, we present a unique case of MRONJ in a patient with no history of antiresorptive or antiangiogenic drug use, who was instead taking the anti-interleukin 17-A (Secukinumab) medication for severe psoriasis. This association has not been previously reported in the literature.
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- MeSH
- antibakteriální látky * aplikace a dávkování terapeutické užití MeSH
- antibiotická profylaxe MeSH
- bakteriální infekce prevence a kontrola MeSH
- lidé MeSH
- perioperační péče metody MeSH
- pooperační komplikace prevence a kontrola MeSH
- rizikové faktory MeSH
- rozvrh dávkování léků MeSH
- stomatochirurgické výkony ošetřování MeSH
- stomatologické nemoci * farmakoterapie MeSH
- úrazy zubů farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
The reconstruction of oral tongue and floor of mouth defects after resections of squamous cell carcinoma is a challenging task in reconstructive surgery aiming for appropriate restoration of oral function and quality of life improvement. In this study, the authors introduce the innovative reconstruction technique of medium-sized defects consisting of tunnelized facial artery myomucosal island flap and submandibular gland flap as the local chimeric flap pedicled on facial vessels. A retrospective case series evaluation of 4 patients suffering from oral cavity cancer (stages III and IVa), who underwent transoral tumor excision with neck dissection and immediate reconstruction in the time period September 2020 to July 2021, was conducted. No flap losses or flap-related complications were identified. No recurrences occurred during the follow-up at 11.0±4.5 months (range: 6-16 mo, median=11 mo). Tunnelized facial artery myomucosal island flap and submandibular gland flap local chimeric flap expands the reconstruction options of medium-sized defects after ablative oral cancer surgery in carefully selected patients primarily not suitable for free flap reconstructions.
- MeSH
- arterie MeSH
- chirurgické laloky krevní zásobení MeSH
- dlaždicobuněčné karcinomy hlavy a krku MeSH
- kvalita života MeSH
- lidé MeSH
- nádory hlavy a krku * MeSH
- nádory úst * chirurgie patologie MeSH
- podčelistní slinná žláza chirurgie patologie MeSH
- retrospektivní studie MeSH
- spinocelulární karcinom * chirurgie patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: An ocular adnexal apocrine adenocarcinoma (OAAA) is an extremely rare, but potentially aggressive and life-threatening tumor with ill-defined management based only on recommendations from a limited number of reported cases. The development of cervical lymphocele following neck dissection is a very rare complication, but one with well established methods for prevention and treatment. Here we describe a previously unreported case of salvage surgery including neck dissection for OAAA in addition to an emergence of cervical lymphocele. A literature review of current knowledge on both pathological conditions is included. METHODS AND RESULTS: A 58-year-old man suffering from OAAA, previously treated with multiple eye-sparing excisions and adjuvant proton therapy, underwent salvage surgery for locoregional recurrence of the tumor. A partial orbitectomy with orbital exenteration, primary reconstruction and left-sided neck dissection was performed. The procedure was complicated by a cervical lymphocele resolved after the surgical therapy. The patient remained disease-free during the one-year follow-up. CONCLUSION: OAAA is a locally aggressive tumor with potential to local or distant metastatic spread. Whole-body staging, regular clinico-radiological follow-up and stage-dependent therapy with surgery as the first-choice treatment is required. A cervical lymphocele as a complication of especially left-sided neck dissection is managed with a conservative or surgical therapy according to the level of lymph leakage, extent and localization of lesions, presence of local or systemic disorders and the period from primary surgery.
- MeSH
- adenokarcinom * patologie chirurgie MeSH
- krční disekce škodlivé účinky metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- lymfokela * etiologie chirurgie MeSH
- nádory prsu * chirurgie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
