Abstract

The aim of the work was to highlight clinical manifestations and symptoms, histology and diagnostic methods, treatment of patients with MNO (malignant neoplasms of the orbit) and PS (paranasal sinuses) with growth into the orbit. Determination of the optimal surgical approach that allows radical removal of malignant neoplasms of orbital, cranio-orbital localization with maximum preservation of the functions of the visual analyzer. Materials and methods: the article considers and analyzes the results of treatment of 23 patients with malignant craniobital, orbital tumors and 35 patients with PS tumors that spread into the orbit. All patients, aged 2 to 85 years, were operated on in the clinic of neurosurgery and ENT diseases DCMA in Donetsk in the period from 2015 to October 2020. The conclusions were drawn: FOZ (frontal-orbito-zygomatic approach) is shown to remove orbital and cranio-orbital tumors of gigantic sizes, causing a sharp compression of the structures of the orbit, brain and tumors involving bone structures in the process. This type of operative approach allows performing organ-preserving operations with maximum radicalism, in relation to malignant neoplasms, with minimal complications, and maximum preservation of visual function.

An external (facial or sublabial) approach is optimal for the removal of the MN (malignant neoplasm) of the anterior PS group (frontal, maxillary, anterior ethmoid cells) that extend into the orbit.

In case of MN of posterior group (sphenoid sinus and posterior ethmoid labyrinth cells), as a rule, an endonasal endoscopic approach is used, which allows a good overview of this anatomical region. The previously proposed scheme for determining the choice of surgical approach to orbital neoplasms has successfully justified itself in practice [7,8], which is reflected in the results of treatment of patients with malignant tumors presented in the article.

Treatment of malignant neoplasms of the indicated location is always complex. Surgical treatment as the first stage. The second stage, depending on the histological response, is chemotherapy or radiation therapy.

Keywords: Orbital Malignant Tumor; Ptosis; FOZ; Sub; Transconjunctival Approach; Canthotomy; Orbital Exenteration; RMS

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