Skip to main content

Advertisement

SpringerLink
Log in

A multidisciplinary approach to tumours involving the orbit: Orbital re-construction, a 3-dimensional concept

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Radical tumour removal in the region of the anterior skull base with involvement of the orbit requires not only good exposure but also acceptable reconstruction with good cosmesis, no visible scars and no injury to the eye.

The possible approaches, which should be flexible and adapted to the location and extent of the pathology and the appropriate methods of reconstruction, are illustrated by four patients. The relevant literature is reviewed. Emphasis on the need for a 3-dimensional concept in the reconstruction and the importance of a multi disciplinary team is stressed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Altemir FH (1986) Transfacial access to the retromaxiallary area. J Maxfac Surg 14: 165–170

    Google Scholar 

  2. Anand VK, Harkey LH, Al-Mefty O (1991) Open door maxillotomy approach for lesions of the clivus. Skull Base Surg 1: 217–224

    Google Scholar 

  3. Antonyshyn O (1992) Rigid fixation of orbital structures. In: Yaremchuk MJ, Gruss JS, Manson PN (eds) Rigid fixation of the craniomaxillofacial skeleton. Butterworth-Heinmann, Boston, pp 302–316

    Google Scholar 

  4. Archer D, Young S, Uttley D (1987) Basilar aneurysms: a new transclival approach via maxillotomy. J Neurosurg 67: 54–58

    Google Scholar 

  5. Argenta LC, Friedman RJ, Dingman RO,et al (1985) The versatility of pericranial flaps. Plast Reconst Surg 76: 695–702

    PubMed  Google Scholar 

  6. Brown AMS, Lavery B, Millar B (1991) The transfacial approach to the post nasal space and retromaxillary structures. Brit J Oral Maxfac Surg 29: 230–236

    Google Scholar 

  7. Cocke EW, Robertson JH, Robertson JT,et al (1990) The extended maxillotomy and subtotal maxillectomy for excision of skull base tumours. Arch Otolaryngol Head Neck Surg 116: 92–104

    PubMed  Google Scholar 

  8. Fukuta K, Jackson IT (1993) Orbital neurofibromatosis with enophthalmos. Brit J Plast Surg 46: 36–38

    PubMed  Google Scholar 

  9. Gruss JS, Phillips JH (1989) Complex facial trauma: the evolving role of rigid fixation and immediate bone graft reconstruction. Clin Plast Surg 16: 93–104

    PubMed  Google Scholar 

  10. Gruss JS (1992) Craniofacial osteotomies and rigid fixation in the correction of post traumatic craniofacial deformities. In: Yaremchuk MJ, Gruss JS, Manson PN (eds) Rigid fixation of the craniomaxillofacial skeleton. Butterworth-Heinmann, Boston, pp 283–301

    Google Scholar 

  11. Gruss JS (1992) Rigid fixation of nasoethmoid-orbital fractures. In: Yaremchuk MJ, Gruss JS, Manson PN (eds) Rigid fixation of the craniomaxillofacial skeleton. Butterworth-Heinmann, Boston, pp 283–301

    Google Scholar 

  12. Ilankovan V, Jackson IT (1992) Experience in the use of calvarial bone grafts in orbital reconstruction. Brit J Oral Maxfac Surg 30: 92–96

    Google Scholar 

  13. Jackson IT (1985) Craniofacial approach to tumours of the head and neck. Clin Plast Surg 12: 375–388

    PubMed  Google Scholar 

  14. Jackson IT: Management of craniofacial tumours. In: Caronni EP (ed) Craniofacial Surgery. Little Brown, Boston, pp 315–347

  15. Jackson IT, Marsh WR, Bite U,et al (1986) Craniofacial osteotomies to facilitate skull base tumour resection. Brit J Plast Surg 39: 153–160

    PubMed  Google Scholar 

  16. Jackson IT, Adham MN, March R (1986) Use of the galeal frontalis myofacial flap in craniofacial surgery. Plast Reconst Surg 77: 905–910

    PubMed  Google Scholar 

  17. Jackson IT (1989) Classification and treatment of orbito-zygomatic and orbito-ethmoid fractures. Clin Plast Surg 16: 77–91

    PubMed  Google Scholar 

  18. Jackson IT (1992) Calvarial bone for head and neck reconstruction. In: Jackson IT, Sommerland BC (eds) Recent advances in plastic surgery, 4th Ed. Churchill Livingstone, Edinburgh, pp 93–108

    Google Scholar 

  19. Janecka IP, Sen CN, Sekhar LN,et al (1990) Facial translocation: a new approach to the cranial base. Otolaryngol Head Neck Surg 103: 413–419

    PubMed  Google Scholar 

  20. Janecka IP, Nuss DW, Sen CN (1991) Midface split for access to the central skull base. Acta Neurochir (Wien) [Suppl] 53: 199–203

    Google Scholar 

  21. Janecka IP, Sekhar LN (1991) Reconstruction of skull base defects. In: Jackson CG (ed) Surgery of skull base tumours. Churchill Livingstone, Edinburgh, pp 251–272

    Google Scholar 

  22. Johns ME, Winn HR, McLean WC,et al (1981) Pericranial flap for the closure of defects of craniofacial resections. Laryngoscope 91: 952–959

    PubMed  Google Scholar 

  23. Munro IR, Lauritzen CGK (1985) Periorbital tumours. In: Caronni EP (ed) Craniofacial surgery. Little Brown, Boston, pp 329–344

    Google Scholar 

  24. Neil-Dwyer G, Sharr M, Haskell R,et al (1988) Zygomatictemporal approach to the basis cranial and the basilar artery. Neurosurgery 23: 20–22

    PubMed  Google Scholar 

  25. Nuss DW, Janecka IP, Sekhar LN,et al (1991) Craniofacial disassembly in the management of skull base tumours. Otolaryngol Clin North Am 24: 1465–1497

    PubMed  Google Scholar 

  26. Obwegesser HL (1985) Temporal approach to the TMJ, orbit and the retromaxillary-infracranial region. Head Neck Surg 7: 185–199

    PubMed  Google Scholar 

  27. Penfold CN, Lang DA, Evans BT (1992) The management of orbital roof fractures. Brit J Oral Maxfac Surg 30: 97–103

    Google Scholar 

  28. Posnick JC (1992) The role of plate and screw fixation in the management of paediatric head and neck tumours. In: Yaremchuk MJ, Gruss JS, Manson PN (eds) Rigid fixation of the craniomaxillofacial skeleton. Butterworth-Heinmann, Boston, pp 652–670

    Google Scholar 

  29. Sialler HF (1992) Surgical approaches for removal of orbital tumours including a new access to the medical walls. Abstract: 11th Congress of European Association for Cranio-Maxillo-Facial Surgery. J Craniomaxfac Surg 20: [Suppl 1]: 5

    Google Scholar 

  30. Salyer KE (1981) Recent developments in bone grafting. In: Jackson IT (ed). Recent developments in plastic surgery, 2nd Ed. Churchill Livingstone, Edinburgh, pp 225–240

    Google Scholar 

  31. Snyderman CH, Janecka IP, Sekhar LN,et al (1990) Anterior cranial base reconstruction: role of galeal and pericranial flaps. Laryngoscope 100: 608–614

    Google Scholar 

  32. Tessier P (1982) Autogenous bone graft taken from the calvarium for facial and cranial applications. Clin Plast Surg 9: 531–538

    PubMed  Google Scholar 

  33. Uttley D, Moore A, Archer DJ (1989) Surgical management of midline skull base tumours: a new approach. J Neurosurg 71: 705–710

    Google Scholar 

  34. Wei WI, Lam KH, Sham JST (1991) New approach to the nasopharynx: the maxillary swing approach. Head Neck Surg 13: 201–207

    Google Scholar 

  35. Wolfe SA (1989) Orbital Tumours. In: Wolfe SA, Berkowitz S (eds) Plastic surgery of facial skeleton. Boston, Little Brown, pp 625–658

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Southampton University Hospitals, Southampton, UK

    D. A. Lang & G. Neil-Dwyer

  2. Department of Faciomaxillary Surgery, Southampton University Hospitals, Southampton, UK

    B. T. Evans

Authors
  1. D. A. Lang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Neil-Dwyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. T. Evans
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lang, D.A., Neil-Dwyer, G. & Evans, B.T. A multidisciplinary approach to tumours involving the orbit: Orbital re-construction, a 3-dimensional concept. Acta neurochir 128, 101–108 (1994). https://doi.org/10.1007/BF01400658

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01400658

Keywords

Search

Navigation