A 60-year-old man with squamous cell carcinoma of the right maxillary sinus undergoes imaging that shows tumour eroding the orbital floor with extension into the orbital fat. According to conventional management of advanced maxillary sinus cancer, the appropriate surgical procedure is:

• A Infrastructure maxillectomy
• B Total maxillectomy with orbital exenteration ✓
• C Total maxillectomy preserving the orbit
• D Endoscopic medial maxillectomy with adjuvant radiotherapy

Explanation

Gross invasion of the orbit beyond the periosteum, here into orbital fat, mandates total maxillectomy combined with orbital exenteration, since preserving the eye over gross disease compromises oncological clearance. Infrastructure maxillectomy is limited to alveolar and palatal disease below Ohngren's plane. Total maxillectomy with orbital preservation is appropriate when disease respects the periorbita. Endoscopic medial maxillectomy suits limited low-stage tumours of the lateral wall.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.