xRead - Nasal Obstruction (September 2024) Full Articles

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KUANetal.

TABLE XI.2 (Continued)

Clinical endpoints 1. Surgical

Study

Year LOE Study design Study groups

Conclusion

Ferrari et al. 220

1. Orbital sparing surgery can be considered when there is no intraconal fat or EOM disease 2. MRI can often mis-stage orbital invasion particularly in case of prior surgery or CRT 3. Involvement of extraconal fat shows decreased DFS

2021

4

Retrospective case series

Cohort was divided into six different groups (A–F) based on radiologic characteristics of orbital invasion using Iannetti 324 and Turri-Zanoni 165 criteria Orbital preservation surgery ( n = 76) or orbital ablation ( n = 47) Grade I: Orbital bone erosion ( n = 27) Grade II - Invasion of extraconal fat ( n = 36) Grade III - Involvement of EOMs, eye globe, orbital apex, or optic nerve ( n = 30) Grade 1: Orbital bone erosion ( n = 44) Grade 2: Invasion of the periorbital layer and/or periorbital fat ( n = 46) Grade 3: Invasion of the extrinsic ocular muscles, optic nerve, ocular bulb ( n = 49) Grade 4: Involvement of the orbital apex ( n = 24) Single cohort ( n = 41) separated into orbital invasion categories: (1) Loss of fat plane between tumor and EOMs. (2) Irregular, nodular tumor margin along the periorbita. (3) Invasion of EOMs (4) Invasion of the optic nerve

management (orbital sparing, orbital clear ance/exenteration)

2. Diagnostic accuracy of MRI in determining stagingof orbital invasion 1. OS 2. LRFS 3. 5-year PFS

Li et al. 164

2020 4

Retrospective case series

Grade III orbital invasion was associated with significantly worse OS, LFRS, and PFS, but did not contraindicate orbit-preserving surgery after RT

1. OS 2. DFS

1. Orbital invasion is a significant prognostic factor 2. DFS and OS relatively unaffected by degree of invasion, implying organ preservation is critical when possible 3. Induction chemo can downstage tumors

Turri-Zanoni et al. 165

2019 4

Retrospective case series

Christianson et al. 336

2015 4

Retrospective case series

1. Analysis of operative techniques 2. LR

1. Orbital involvement excluding categories 3 and 4 was managed with orbital preservation 2. No significant increase was seen in local or regional recurrence 3. Local control was key in treatment

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