Management of the orbit in malignant sinonasal tumors

Suárez, Carlos; Ferlito, Alfio; Lund, Valerie J.; Silver, Carl E.; Fagan, Johannes J.; Rodrigo, Juan P.; Llorente, José Luís; Cantù, Giulio; Politi, Massimo; Wei, William I.; Rinaldo, Alessandra

doi:10.1002/hed.20736

Cited by 110 publications

(87 citation statements)

References 39 publications

(69 reference statements)

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“…The techniques used include prostheses, obturation, pedicled and free flaps 17,35,36 . To exemplify the difficulties in the surgical management of sinonasal tumors, we present a case of a 61-year-old woman who referred to our clinic for left nasal obstruction, rhinorrhea, repeated epistaxis, anosmia, left hemifacial paraesthesia, exophthalmos, epiphora and vision impairment in the left eye ( Figure 4, Figure 5).…”

Section: Sinonasalmentioning

confidence: 99%

Difficulties in the surgical management of head and neck cancer patient

Sarafoleanu

Vuzitas

Manea

2017

Romanian Journal of Rhinology

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Malignancies of the upper aerodigestive tract are high morbidity bearing and life-threatening diseases, which require thorough care from diagnostic suspicion and confirmation to surgical and/or oncologic treatment and rehabilitation. Difficulties in managing head and neck cancers arise from delays in diagnosis and treatment caused by either patient-related factors or healthcare system-related factors. Tumor origin and stage determine whether surgical excision is feasible, the approach required for safe excision, the extent of functional and aesthetic sacrifice required to attain oncologic safety and the need for reconstructive surgery. A thorough and systematic preoperative risk versus benefits assessment to select potential surgical candidates and give realistic outcomes is important from both a medical and a legal point of view. Because tumors in the head and neck region frequently involve more than one system and sensory organ, potential loss of function from either the disease course, surgical or nonsurgical treatment should be taken into account form a quality of life perspective. Effective management of head and neck cancer patients requires the cooperation and combined effort of a multidisciplinary team of surgeons, physicians and other workers over a long period of time which, in the absence of a specialised head and neck cancer centre and guidelines, can lead to increased morbidity and mortality, and patient dissatisfaction.

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Section: Sinonasalmentioning

confidence: 99%

Difficulties in the surgical management of head and neck cancer patient

Sarafoleanu

Vuzitas

Manea

2017

Romanian Journal of Rhinology

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“…However, it resulting in loss of visual function and disfigurement for the patient, producing a serious decline in quality of life. On the other hand, some studies show that the surgical removal of the invaded orbital organ in cases of carcinomas did not benefit patient survival [7,19]. Otherwise, preservation of orbital contents during surgical resection of malignant tumors encroaching on the orbit remains a controversial issue [8].…”

Section: Orbital Preservation In Malignant Tumorsmentioning

confidence: 99%

Endonasal Endoscopic Approach for Primary and Secondary Orbital Lesions

Garcia¹,

Pérez²,

Perdomo³

et al. 2017

J Clin Exp Ophthalmol

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Purpose: To describe the results of endonasal endoscopic resection for primary and secondary orbital lesions.Design: A retrospective cohort study was performed. Subjects:The clinical data of patients with primary and secondary orbital tumors who received treatment with endonasal endoscopic surgery from Agost 2016 to July 2017 in the Department of Head and Neck Surgery of the National Institute of Oncology and Radiobiology (Cuba) were analysed.Intervention: All surgeries were performed by using Karl Storz 00, 450 and 700, 4 mm diameter; 18 cm rod-lens rigid telescopes (Karl Storz and Co, Tuttlingen, Germany). Endonasal endoscopic transethmoidal route was the primary approach, and according to the tumor size, histology and location, a transantral route was aggregate. Main outcome measures:Demographic data, histology nature of the lesions, clinical presentation, surgical route, frozen section margins and complications relative to treatment were obtained. Grade of resection was measured.Results: From total of 12 patients that were interview, 7 were male and 5 female. Age range was 20-70 years and a mean age of 50.2 years. According to nature of the lesions, seven patients have malignant neoplasm and three patients have non-neoplasic disorders. Transethmoidal route was performed in 4 patients and transethmoidal/ transantral in 8 patients. Total resection was achieved in 11 patients (92%). Frozen section margins were negative in all patients. All patients experienced complete resolution of the presenting symptoms with no evidence of optic nerve injury. Two patients presented transient ophtalmoparesis. Conclusion:Endonasal endoscopic surgery is a safe, successful and minimally invasive technique for resecting extra-intraconal primary and secondary orbital tumors; especially those arise posterior to the ocular glove and inferomedially of optic nerve. There are some important key points to take account in order to prevent complications.

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“…MRI shows soft tissue involvement clearly, indispensable in the planning of treatment and post therapy evaluation of sinus tumors [5].…”

mentioning

confidence: 99%