Management of the orbit during endoscopic sinonasal tumor surgery

Brandon Christianson, Carlos Perez, Brian Harrow, Pete S. Batra

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background: The primary aims of the study were to report preoperative imaging characteristics and intraoperative management of the orbit during endoscopic resection of benign and malignant sinonasal tumors. Methods: This study was a case series at an academic tertiary care center. Retrospective chart review and prospective imaging assessment was performed on 159 cases treated between July 2009 and December 2012. Results: A total of 41 patients met predetermined inclusion criteria. Squamous cell carcinoma (17.1%) and inverted papilloma (31.7%) were the most common malignant and benign histology, respectively. Preoperative computed tomography (CT) scanning most commonly demonstrated erosion of the lamina papyracea (80.5%), whereas magnetic resonance imaging (MRI) most commonly illustrated loss of fat plane between tumor and extraocular muscle (53.1%). Endoscopic procedures to address the orbital interface included lamina papyracea resection (85.4%), dacryocystorhinostomy (26.8%), periorbita resection (26.8%), optic nerve decompression (7.3%), and orbital exenteration (2.4%). Oculoplastic surgery involvement was required in 31.7% of cases. Orbital complications included epiphora in 3 (7.3%) and diplopia in 2 (5.1%) patients. Postoperatively, no recurrences were noted in the benign group, whereas 6 (28.6%) recurrences were noted in 21 patients in the malignant group treated with intent to cure. Two patients died of disease due to distant metastases from mucosal melanoma and squamous cell carcinoma. Conclusion: This represents the largest series to date on endoscopic management of the orbit in benign and malignant sinonasal tumors. A majority of these cases can be managed by a purely endoscopic approach with low complication and recurrence rates, although a subset still require adjunct open approaches for successful tumor extirpation.

Original languageEnglish (US)
Pages (from-to)967-973
Number of pages7
JournalInternational Forum of Allergy and Rhinology
Volume5
Issue number10
DOIs
StatePublished - Oct 1 2015

Keywords

  • Computed tomography
  • Endoscopy
  • Magnetic resonance imaging
  • Neoplasm
  • Orbit
  • Tumor

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

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