Management of orbital invasion in sinonasal malignancies

Head Neck. 2016 Nov;38(11):1650-1656. doi: 10.1002/hed.24490. Epub 2016 Apr 30.

Abstract

Background: Indications for preservation of orbital contents in case of malignant sinonasal tumors invading the orbit remain controversial.

Methods: A retrospective consecutive review was conducted of patients in a tertiary care center over a 15-year period.

Results: Ninety-three patients were diagnosed with a malignant tumor invading the orbit. Eighty-three were treated with curative intent of which 58 underwent surgery. Mean follow-up was 45 months. Orbital preservation was feasible in 66% of cases, whereas orbital clearance was performed in cases of locally advanced disease (invasion of extraocular muscles, ocular globe, or orbital apex). Local control rate was 70% for patients treated with orbital clearance and 74% for those with orbital preservation, with no statistical difference. Five-year survival and 5-year relapse-free survival were similar in both groups.

Conclusion: Using our strategy, the eye can be spared in more patients than what is currently proposed, without oncologic or survival disadvantages. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.

Keywords: orbital clearance; orbital invasion; orbital preservation; sinonasal malignancy; transfacial approach.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local
  • Orbital Neoplasms / mortality
  • Orbital Neoplasms / pathology*
  • Orbital Neoplasms / surgery
  • Orbital Neoplasms / therapy
  • Paranasal Sinus Neoplasms / mortality
  • Paranasal Sinus Neoplasms / pathology*
  • Paranasal Sinus Neoplasms / surgery
  • Paranasal Sinus Neoplasms / therapy
  • Retrospective Studies
  • Survival Analysis