Orbital Complications of Sino Nasal Tumors

Abstract

Orbital involvement in Sinonasal tumours most commonly present as proptosis, epiphora and/or visual symptoms. We aimed to enumerate the orbital manifestations of Sino nasal tumours, to describe strategies employed to manage orbit and vision, to evaluate outcomes, vision preservation and survival rates. This retrospective study spanning ten years identified 147 Sino nasal pathologies with clinic-radiological involvement of the orbit. Of the 147 cases, 35 were diagnosed as Sino nasal tumours with orbital involvement. Patients with sinonasal symptoms without clinical involvement of orbit and those with primary orbital pathology were excluded. Of the 35 patients, histopathology revealed benign and malignant tumours in 17(48.6%) and 18(51.4%) patients respectively. Inverted papilloma and squamous carcinoma were the most common benign and malignant diagnoses, respectively. Proptosis was the most common orbital symptom (42.9%) and reduced ocular motility were noted in 22.8%. Orbit preservation was achieved in all 17 cases with benign disease. Among those with malignant disease, 15 (83%) underwent globe-sparing surgeries and 3(17%) underwent orbital exenteration. Normal orbital function was retained in 6(33%) of the 15 patients. Orbital involvement in sinonasal tumours can be indicators of either chronicity or aggressive disease course. Compressive symptoms were common in benign aetiologies. In our series, orbital preservation was obtained in resection of all benign tumours. Orbital preservation was achieved in most patients with malignant disease. Histology, extent of surgery and follow up determined overall outcome in these patients.

Keywords: Malignancy; Orbit; Orbit preservation; Sinonasal; Tumour.