A 60-year-old man with a T4aN0M0 squamous cell carcinoma of the maxillary sinus has upward displacement of the orbit on CT scan. The tumor erodes the posterolateral walls and the orbital floor but does not penetrate the orbital periosteum. What is the recommended management regarding the eye?

• A Orbital exenteration is mandatory
• B The eye must be sacrificed if the orbital floor is eroded
• C Enucleation followed by radiation
• D The orbit can be preserved if the periorbita is not invaded ✓

Explanation

In maxillary sinus carcinoma, orbital exenteration is indicated only when the tumor penetrates the orbital periosteum (periorbita) or invades the orbital fat or muscles. If the periorbita is intact, even with erosion of the orbital floor and upward displacement of the globe, the orbit can be preserved during radical maxillectomy. Sacrificing the eye when the periorbita is intact unnecessarily reduces the patient's quality of life without oncologic benefit.

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

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Written and medically reviewed by the StethoPrep medical team.