RESUMEN
The prevalence of residual epiphora following successful periocular surgery for facial nerve paralysis can be as high as 30% or more. The pathophysiology of residual epiphora is complex, but identification of the etiology is paramount because the therapeutic approach varies accordingly. Treatments range from medical management of systemic disease to botulinum toxin injections for conditions that arise from aberrant reinnervation to surgical procedures that bypass the lacrimal drainage system completely. We describe a case report and review the pathophysiology and management of residual epiphora to provide a treatment algorithm for clinical use by facial plastic and oculoplastic surgeons. Laryngoscope, 131:E420-E422, 2021.
Asunto(s)
Parálisis Facial/cirugía , Enfermedades del Aparato Lagrimal/etiología , Neoplasias de los Nervios Craneales/cirugía , Nervio Facial/cirugía , Enfermedades del Nervio Facial/cirugía , Femenino , Humanos , Enfermedades del Aparato Lagrimal/fisiopatología , Enfermedades del Aparato Lagrimal/terapia , Persona de Mediana Edad , Lágrimas/fisiologíaRESUMEN
The purpose of this study was to evaluate the long-term outcome and patterns of failure in patients treated with primary radiotherapy (RT) for orbital lymphoma (OL). Seventy-nine patients diagnosed with stage IE OL between 1995 and 2012 were included. Fifty-nine patients (75%) had mucosa-associated lymphoid tissue lymphoma and 20 patients (25%) had follicular lymphoma subtype. The median follow-up was 49.7 months. Major tumor sites were conjunctiva (29%), orbit (47%) and lacrimal gland (24%). After treatment to a median dose of 30.6 Gy, there were a total of no local, one contralateral orbital, two regional and two distant recurrences, all outside of the treatment fields. The 10-year local relapse-free, distant metastasis-free and overall survival rates were 100%, 94.2% and 98.2%, respectively. Definitive RT to 30 Gy was shown to be highly effective for indolent OL, and this study represents one of the largest single-institution studies using primary RT for stage IE OL.
Asunto(s)
Linfoma/radioterapia , Neoplasias Orbitales/radioterapia , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Linfoma/mortalidad , Linfoma/patología , Linfoma de Células B de la Zona Marginal/mortalidad , Linfoma de Células B de la Zona Marginal/patología , Linfoma de Células B de la Zona Marginal/radioterapia , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Orbitales/mortalidad , Neoplasias Orbitales/patología , Factores de Tiempo , Insuficiencia del Tratamiento , Resultado del Tratamiento , Adulto JovenRESUMEN
Major head and neck resections may result in ocular defects that are functionally and/or aesthetically incapacitating. Restoration of the eyelid and orbit must address lateral canthal laxity, midface ptosis, eyelid retraction and ptosis, globe malposition, and dysfunctional lacrimal drainage. Here we discuss lateral canthal reconstruction, midface-lifting, eyelid spacer grafts, gold weight placement, surgical approaches to the orbit, free flap options for orbital reconstruction, and endoscopic lacrimal surgery. Successful outcomes in eyelid and orbital reconstruction depend upon proper knowledge, planning, and multidisciplinary management.