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Extreme Cancer of the Periorbital Region

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Abstract

This chapter is a collaborative effort from an oculoplastic surgeon and plastic surgeons. It considers the unique functional anatomy of the eyelids, globe, orbital contents, regional relationships and visual physiology. A variety of cancers occur in the periorbital region. The commonest are basal cell (BCC), squamous cell (SCC), sebaceous gland (SGC), Merkel cell carcinomas and cutaneous melanoma. These cancers can be locally invasive and spread by regional lymphovascular invasion, perineural invasion and in some cases life-threatening distant metastases. Immunocompromised patients can present with extensive cancer spread. Multidisciplinary care optimises the management of these tumours. When managing periocular cancers, the preservation of eyesight is an obligatory consideration. However, in some cases vision has to be sacrificed to achieve an optimal oncological result or to preserve life. Surgical margins of cancers invading the orbit are ill-defined, necessitating aggressive multimodality therapy. In surgical reconstruction, special attention must be given to preserving (1) ocular motility and (2) the protective function of the eyelids while retaining (3) an adequate palpebral aperture for vision. Preserving an eye’s tear film and an adequate tear outflow system is also vital for maintaining eyesight and a patient’s quality of life.

Keywords

  • Orbital and eyelid tumours
  • Multidisciplinary care
  • Preservation of vision
  • Reconstruction of major eyelid defects

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  • DOI: 10.1007/978-3-030-88334-8_12
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Ng, S.G.J., Klaassen, M.F., Brown, E. (2022). Extreme Cancer of the Periorbital Region. In: Burton, I., Klaassen, M.F. (eds) Atlas of Extreme Facial Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-88334-8_12

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  • DOI: https://doi.org/10.1007/978-3-030-88334-8_12

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  • Publisher Name: Springer, Cham

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