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Ocular oncology
Orbital and periocular complications in patients with sinonasal tumours with orbital invasion
  1. Jiawei Zhao1,
  2. Xinyang Jiang2,
  3. Ehab Hanna3,
  4. Shirley Y Su3,
  5. Amy Moreno4,
  6. Brandon Gunn4,
  7. Steven Jay Frank4,
  8. Renata Ferrarotto5,
  9. Jing Ning2,
  10. Bita Esmaeli1
  1. 1 Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  2. 2 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  3. 3 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  4. 4 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  5. 5 Department of Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Dr Bita Esmaeli, Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; besmaeli{at}mdanderson.org

Abstract

Aims The purpose of this study was to determine the frequency and associated risk factors of orbital/periocular complications in patients with sinonasal tumour with orbital invasion managed with eye-sparing treatments.

Methods A retrospective case series of patients with primary sinonasal tumour with orbital invasion from January 2008 to December 2018. Patient factors were compared between the following groups: (1)patients with orbital/periocular complications versus those who did not and (2) patients who needed secondary oculoplastic surgical procedures versus those who did not.

Results Out of 80 patients, 48 had eye-sparing surgery, 8 had orbital exenteration and 24 were managed non-surgically. The most common histology was squamous cell carcinoma (n=28, 35%). Among the eye-sparing treatment group, 51/72 patients experienced one or more orbital/periocular complication(s), with motility deficit (N=26, 36%) being the most frequent. Factors associated with higher risk of complications included tumour involving the orbital floor (p=0.019), clinical disease stage III/IV (p=0.038), maxillectomy (p=0.004), resection of the orbital floor (p=0.027) and cigarette smoking (p=0.041). Tumour involving the orbital floor had an OR of 3.9 (95% CI 1.3 to 11.6, p=0.016) in predicting orbital/periocular complication. In the eye-sparing surgery group, the most frequent secondary oculoplastic procedures was dacryocystorhinostomy (n=6, 13%). The use of a free flap in reconstruction had an OR of 8.2 (95% CI 2.1 to 31.8, p=0.002) in predicting need for secondary oculoplastic surgery.

Conclusion Majority of patients with sinonasal tumours and secondary orbital invasion were managed with eye-sparing multidisciplinary treatments. Preservation of the eye can lead to reasonably good functional outcome despite expected orbital and periocular complications.

  • Orbit
  • Eye Lids
  • Lacrimal drainage
  • Neoplasia

Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/bjo-2022-322855

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    Data availability statement

    Data are available on reasonable request.

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    Footnotes

    • Contributors All authors have contributed to the paper according to the ICMJE guidelines for authorship. JZ: conception and design of the study, and the acquisition, analysis and interpretation of data, drafting the work and revising it critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work. XJ: analysis and interpretation of data, revising the paper critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work. EH: revising the paper critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work. SYS: revising the paper critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work. AM: revising the paper critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work. BG: revising the paper critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work. SJF: revising the paper critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work. RF: revising the paper critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work. JN: analysis and interpretation of data, revising the paper critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work. BE: conception and design of the study, analysis and interpretation of data, drafting the paper and revising it critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work as the guarantor.

    • Funding This work was supported by the National Institutes of Health/NCI under award number P30CA016672.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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