title: Management of the orbit in malignant sinonasal tumors.
abstract: 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.
authors.affiliation: Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Suárez
authors.forename: Alfio
authors.initials: A
authors.lastname: Ferlito
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Lund
authors.forename: Carl E
authors.initials: CE
authors.lastname: Silver
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Fagan
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Rodrigo
authors.forename: José L
authors.initials: JL
authors.lastname: Llorente
authors.forename: Giulio
authors.initials: G
authors.lastname: Cantù
authors.forename: Massimo
authors.initials: M
authors.lastname: Politi
authors.forename: William I
authors.initials: WI
authors.lastname: Wei
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rinaldo
mesh_terms: D005005:Ethmoid Sinus / Q000473:pathology; D006801:Humans; D008444:Maxillary Sinus Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D009361:Neoplasm Invasiveness; D009915:Orbit / Q000473:pathology*; D010255:Paranasal Sinus Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps