Orbital Exenteration in Sinonasal Tumor: Surgical Outcome and Rehabilitation

Kang, Woo Seok; Chung, Yoo Sam; Jang, Yong Ju; Lee, Bong Jae

Abstract

BACKGROUND AND OBJECTIVES
The decision whether or not to preserve orbital contents during surgical resection of malignant tumors involving the sinonasal tract and the orbit has been an issue of controversy. The purpose of this study is to review our outcomes of the orbital exenteration and rehabilitations, and to present the usefulness of orbital rehabilitations. SUBJECTS AND METHOD: A retrospective analysis was done for 10 patients who underwent orbital exenteration between Feb 1995 and Apr 2003. RESULTS: The age of patients ranged from 23 to 71 years (mean 49.7 years), and the male: female ratio was 1: 1. The follow-up period after orbital exenteration ranged from 3 to 108 months (mean 33.2 months). Rhabdomyosarcoma and squamous cell carcinoma represented the largest group (three patients respectively). Maxillary sinus was the most common primary site (five patients). Local sinonasal recurrence was noted in two patients, and distant metastasis was observed in one patient. Six patients have survived for more than 20 months. No orbital rehabilitation and reconstruction was done in six patients, silicone orbital prosthesis in two patients, artificial eye in one patient, and free flap in two patients. All patients who had orbital rehabilitation showed great satisfaction. CONCLUSION: Rhabdomyosarcoma and squamous cell carcinoma were the two most common malignancy requiring orbital exenteration. More than half of the patients have survived for 20 months or longer. Rehabilitation such as ocular prosthesis can be considered for better cosmetic appearances.