Department of Head and Neck Surgery and Oncology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Head Neck. 2013 Oct;35(10):1379-84. doi: 10.1002/hed.23137. Epub 2012 Sep 13.
The purpose of this study was to analyze the oncologic and functional outcomes of the preserved eye in malignant sinonasal tumors with orbital involvement.
In a retrospective study of 19 consecutive patients who underwent craniofacial resection or maxillectomy with preservation of orbital contents and adjuvant radiotherapy, the oncological outcome in terms of local recurrence and survival was analyzed. The functional outcome in the preserved eye was analyzed for the cases that did not recur in the orbit.
Nineteen patients were analyzed for their oncologic and functional outcomes. Fifteen patients underwent immediate reconstruction of the orbital support. Eight patients had local recurrences; 11 patients were disease free at the end of the follow-up. Squamous cell carcinoma has a high propensity for local recurrences (ie, 5 of 8 local recurrences were squamous cell carcinoma). Sixteen patients, in whom a satisfactory orbital tumor clearance was obtained, remained recurrence free in the orbit. All the preserved eyes retained adequate function after adjuvant radiotherapy.
Adequate local control with preserved visual function can be obtained with surgery and adjuvant radiation in appropriately selected malignant sinonasal tumors with orbital involvement. The preserved eye, if reconstructed appropriately, maintains good overall function with acceptable morbidity.
本研究旨在分析伴眼眶累及的恶性鼻腔鼻窦肿瘤患者保眼治疗的肿瘤学和功能结局。
回顾性分析 19 例接受颅面切除术或上颌骨切除术且保留眶内容物及辅助放疗的患者，分析局部复发和生存的肿瘤学结局。对未发生眼眶复发的病例，分析保眼的功能结局。
19 例患者的肿瘤学和功能结局得到了分析。15 例患者行即刻眶内容物重建。8 例发生局部复发，11 例患者在随访结束时无疾病。鳞状细胞癌具有较高的局部复发倾向（即，8 例局部复发中有 5 例为鳞状细胞癌）。16 例患者获得了满意的眶内肿瘤清除，眼眶内无复发。所有接受辅助放疗的保留眼均保留了足够的功能。
对于适当选择的伴眼眶累及的恶性鼻腔鼻窦肿瘤，手术和辅助放疗可获得足够的局部控制并保留视力功能。如果进行适当的重建，保留的眼睛可保留良好的整体功能，且具有可接受的发病率。
