{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:04:10Z","timestamp":1790247850129,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Orbital exenteration (OE) impacts patients cosmetically, functionally, and psychosocially. Eye\u2010sparing strategies with the advent of immunotherapy have developed the potential to avoid OE but may result in suboptimal oncologic outcomes and reduced survival. This study assesses patients' perceptions regarding quantity versus quality of life when considering OE compared to alternative treatment modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Mixed\u2010methods study, utilizing quantitative health utility tasks and qualitative patient interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty\u2010one patients previously treated for head or neck cutaneous malignancies completed interviews utilizing well\u2010established methodology to assess health state utility values (HSUVs) through time trade\u2010off and standard gamble tasks. This methodology assessed the level of risk patients would be willing to accept to avoid OE in the context of alternate treatment options. Open\u2010ended discussions regarding factors influencing decision\u2010making facilitated an inductive qualitative analysis highlighting patient priorities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients were willing to accept 40.6%\u2009\u00b1\u200928.7% risk of death or give up 3.2\u2009\u00b1\u20092.8 years of survival to avoid OE. This translated to an HSUV for OE of 0.68. The main factors influencing treatment decisions were (1) family, (2) healthcare perceptions, (3) age, (4) social consequences, and (5) risk tolerance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The consequences of OE on patients' quality of life impact their decision\u2010making. Patients may be willing to accept relatively high levels of risk to avoid OE. This highlights the importance of eye\u2010sparing strategies and shared decision\u2010making to ensure patient\u2010centered care, which may not be solely prioritized to survival when it comes to OE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.1364","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T10:55:51Z","timestamp":1753786551000},"page":"1170-1181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patient Perspectives of Quality Compared to Quantity of Life Regarding Orbital Exenteration"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0362-5623","authenticated-orcid":false,"given":"Kalpesh","family":"Hathi","sequence":"first","affiliation":[{"name":"Department of Surgery Division of Otolaryngology\u2013Head and Neck Surgery, Dalhousie University Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"MacKay","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Otolaryngology\u2013Head and Neck Surgery, Dalhousie University Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Macfarlane","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology Dalhousie University Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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