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Management of the orbit in malignant sinonasal tumors
Author(s) -
Suárez Carlos,
Ferlito Alfio,
Lund Valerie J.,
Silver Carl E.,
Fagan Johannes J.,
Rodrigo Juan Pablo,
Llorente José L.,
Cantù Giulio,
Politi Massimo,
Wei William I.,
Rinaldo Alessandra
Publication year - 2008
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20736
Subject(s) - medicine , orbit (dynamics) , maxillary sinus , surgery , soft tissue , ethmoid sinus , radiation therapy , mucormycosis , radiology , engineering , aerospace engineering
Malignant ethmoid and maxillary sinus tumors frequently involve the orbit. Orbital involvement is an important prognostic predictor of recurrence‐free, disease‐specific, and overall survival. Most authors agree that orbital preservation as opposed to orbital exenteration or clearance does not result in significant differences in local recurrence or actuarial survival. The eye can be safely preserved in most patients with ethmoid or maxillary sinus cancer invading the orbital wall, including malignancies that invade the orbital soft tissues with penetration through the periorbita provided that they can be completely dissected away from the orbital fat. Malposition of the globe and nonfunctional eyes frequently result when patients have not had adequate rigid reconstruction of the orbital floor, particularly if they have received postoperative radiotherapy. This underscores the importance of such reconstruction. Isolated defects following orbital exenteration may be reconstructed with a temporalis muscle flap. Microvascular free‐tissue transfer is the best option for repair of defects following orbital exenteration and total maxillectomy, although an obturator still has a role in selected patients. © 2007 Wiley Periodicals, Inc. Head Neck, 2008