Treatment Strategies of Orbit in Sinonasal Malignancy Patients with Orbital Invasion

Due to the paranasal sinuses adjacent to the orbit, the sinonasal malignancy is prone to invade the orbit, which is not only the advanced stage of the tumor, but also one of the poor prognostic factors. Preoperative CT and MRI scan and intraoperative frozen section analysis are used to evaluate the orbital invasion of the tumor. Orbital preservation is adopted if the periorbita is not transgressed by tumor. Orbital preservation can be considered if the tumor invades the periorbita and extraconal fat in a limited range, responds well to neoadjuvant chemotherapy, radiotherapy or other multimodality treatment, or has a negative section margin. Orbital exenteration is performed if the tumor extensively invades the periorbita, and invades the extraocular muscle, eyeball and orbital apex. Whether orbital preservation or orbital exenteration is adopted, it should be evaluated and made decision by a multidisciplinary team, and fully communicate with the patient.