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題名 | Orbital Exenteration for Secondary Orbital Tumors: A Series of Seven Cases=接受眼窩摘除術的續發性眼窩腫瘤--七例報告 |
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作者 | 林秀芬; 呂鎮中; 許桓誠; 林淑妍; Lin, Hsiu-fen; Lui, Chun-chung; Hsu, Huan-chen; Lin, Sue-ann; |
期刊 | 長庚醫學 |
出版日期 | 20020900 |
卷期 | 25:9 2002.09[民91.09] |
頁次 | 頁599-605 |
分類號 | 416.75 |
語文 | eng |
關鍵詞 | 眼窩摘除術; 續發性眼窩腫瘤; 基底細胞癌; 鱗狀細胞癌; 橫紋肌肉瘤; Exenteration; Secondary orbital tumors; Split-thickness skin graft; Basal cell carcinoma; Squamous cell carcinoma; Rhabdomyosarcoma; |
中文摘要 | 背景:眼窩摘除術是應用在眼窩組織的惡性腫瘤,包括源發性及續發性手術時,要將眼球及眼眶軟組織、骨膜完全摘除。眼窩摘除術可以分為(1)完全的(2)近乎完全的(3)超乎完全的摘除。在回溯研宄報告中我們發現七位病例接受眼窩摘除術或是加上顳肌移植,並分析其源發位置、組織學報告、治療方式、復發與否。 方法: 從1987年至2001年3月,共有七位病例被納入在本研究中,病患年齡從41歲到68歲,這七例中有兩例是單傳純執行眼窩摘除術,有四例執行眼窩摘除術及由整形外科醫師執行顳肌移植及身體其他部位的植皮。一例執行眼窩摘除術後1.5個月執行顳肌移植。 結果: 這七例的病理報告中,有兩例是基底細胞癌(皮膚),兩例是鱗狀細胞癌(結膜),一例是鱗狀細胞癌(鼻竇),一例是橫紋肌肉瘤(鼻竇),一例是顱內腦膜細胞瘤。有五病例接受放射線治療,兩個病例接受化學治療;有兩例有轉移到腦部且一例因此而死亡;有一例轉移到肝臟而死亡。 結論: 續發性眼窩腫瘤有可能來自於眼窩附近組織,包括鼻竇咽喉、淚囊、結膜、眼瞼、眼球內組織、顱內組織。一旦外直肌或軟組織有影響到,眼窩摘除術是必須執行的。影像學檢查時除了眼球外,也要特別注意頭頸部、咽喉部及鼻竇部份。術前的評估及眼科醫師、神經外科醫師、整形外科醫師、耳鼻喉科醫師一起合作,才能將手術完成。 |
英文摘要 | Background: Exenteration is indicated in patients with malignant neoplasms of orbital contents. It entails the removal of the eyeball together with its entraocular muscles an other soft tissues. Exenterations can be classified into (1) total, (2)subtotal, and (3) supertotal exenteration. Retrospectively study, we reviewed 7 patients that had received exenteration/subtotal exenteration with spontaneous granulation/myocutaneous flap implantation or eyelid-sparing exenterating with myocuaneous flat. Primry lesions, histopathological examination results, treatments, and recurrences are discussed. Methods: A retrospective study of the year 1987 through 2000 disclose 7 patients that underwent exenteration. The patients ranged in age from 41 to 68 years. Two patient underwent total exenteration without socket augmentation; 4 patients underwent exenteration/ subtotal exetnteration with immediate facial recnstruction, and 1 with delayed facial reconstruction. Results: Classification of the 7 patients showed that 2 had basal cell carcinoma of the skin, 2 had squamous cell carcinoma of the conjunctiva, 1 had squamous cell carcinoma of the paranasal sinus, 1 had rhabdomyosarcoma of the paranasal sinus, and 1 had intracranial meningioma. Radiotherapy was performed in 6 of the patients and chemotherapy in 2. Central nerve system invasion was noted in 2 patients, and 1 died due to it. Conclusion: Secondary orbital tumors involved the orbit form adjacent tissues: paranasal sinuses, nasopharynx, lacrimal sac, conjunctiva, eyelid, intraocular tissue, and intracranial tissues. Combined sugeries are necessary for complete tumor removal. And the imaging studies should include the field of the orbit, sinus, and brain to search for the primary lesions. |
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