Radiodermatitis: A Critical Factor in Oculoplastic Surgical Success
Author: Anna Jagielak-Grab
Base Hospital / Institution: Military Institute of Aviation Medicine, Warsaw, Poland
ePoster presentation
Abstract ID: 24-470
Purpose
The study aims to highlight the problem of radiodermatitis and its influence on oculoplastic surgical procedures.
Methods
A 71-year-old woman, who underwent a surgical removal followed by radiotherapy of carcinogenic tissue in the left lower eyelid, reported to the Ophthalmology Department with pain and redness in the left eye. A retracted and pathologically changed left lower eyelid was observed on clinical examination. The Hughes procedure was performed to obtain a histopathological sample and to reconstruct the eyelid. Two weeks after the surgery, a tear in the tarsoconjuctival flap and necrosis of the skin graft were observed. A second reconstructive procedure was performed.
Results
Although the initial results, observed two months after the surgery, were satisfactory, a further follow-up revealed excessive fibrosis in the previously irradiated skin area that led to progressive retraction of the eyelid.
Conclusion
Radiotherapy is a treatment modality for skin cancers that can be introduced as an adjuvant therapy or as a primary method if the surgical treatment is contraindicated. Apart from its beneficial effects on cancer treatment, ionizing radiation results in common adverse reactions in the skin and may lead to the development of radiodermatitis in even half of the patients. Such patients often require reconstructive surgeries in the fields of plastic and oculoplastic surgery. The healing processes in previously irradiated skin are pathologically altered. Impaired neovascularization and excessive fibrosis are the essential factors that may lead to reconstructive surgery failure.
When dealing with a post-radiotherapy patient, it is important to plan the surgery carefully, considering the structurally changed and poorly supplied tissues. The patient’s general condition, selection of instruments, and peri- and postoperative care are the factors that may significantly influence the surgical outcome. Future studies are needed to improve postoperative results.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Paulina | Szabelska | Military Institute of Aviation Medicine, Warsaw, Poland |
| Dominika | Białas | Military Institute of Aviation Medicine, Warsaw, Poland |
| Radosław | Różycki | Military Institute of Aviation Medicine, Warsaw, Poland |
