Orbital exenteration for sinonasal malignancies: indications, rehabilitation and oncologic outcomes

Purpose of review Review the recent literature regarding the management of orbital invasion in sinonasal malignant tumors. Recent findings There is a recent trend in preserving the orbit in cases of minimal invasion of periosteum and limited periorbit involvement, as well as in presence of good response to neoadjuvant chemotherapy, mainly in squamous cell carcinoma and neuroendocrine histologies. Summary The decision about orbital exenteration in cases of sinonasal malignancies is facilitated if the patient already has clear clinical signs of intraconal invasion such as visual loss, restriction of ocular mobility or infiltration of the eyeglobe. However, in borderline situations, confirmation of orbital involvement should be performed intraoperatively. In selected cases with minimal orbital invasion without functional compromise, orbit sparing surgery can be done with acceptable oncological outcomes. Correspondence to Luiz P. Kowalski, MD, PhD, Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, Rua Professor Antonio Prudente, 211, 01509900 Sao Paulo, Brazil. Tel: +55 11 2189 5172; e-mail: lp_kowalski@uol.com.br Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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