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Purpose of Review <p>To synthesize contemporary evidence on multimodality management of sinonasal and anterior skull base malignancies with orbital invasion, with particular emphasis on orbital grading, indications for exenteration, and the expanding role of orbit-preserving strategies.</p> Recent Findings <p>Recent evidence highlights a multidisciplinary shift toward orbit-preserving, function-sparing strategies. Induction chemotherapy and immune checkpoint inhibitors can reduce tumor volume and expand eligibility for orbit-preserving surgery. Advances in endoscopic techniques now safely address select patterns of invasion, while modern radiation modalities improve local control with reduced toxicity. Together, these developments support individualized multimodal protocols that balance oncologic clearance with organ preservation.</p> Summary <p>Oncologic outcomes are driven more by tumor histology and depth and pattern of orbital invasion than by orbital sacrifice itself. In well-selected patients, coordinated use of systemic therapy, advanced surgery, and conformal radiation permits orbit preservation with survival comparable to exenteration, reserving orbital sacrifice for extensive patterns of invasion or pre-treatment dysfunction.</p>

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Sinonasal and Skull Base Neoplasm With Orbital Involvement: Multi-modality Therapy and Indications for Exenteration

  • 期刊论文

  • 发表日期：

    2026年3月25日

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  • Jack L. Birkenbeuel,
  • Kyle K. VanKoevering,
  • Edward C. Kuan

摘要

Purpose of Review

To synthesize contemporary evidence on multimodality management of sinonasal and anterior skull base malignancies with orbital invasion, with particular emphasis on orbital grading, indications for exenteration, and the expanding role of orbit-preserving strategies.

Recent Findings

Recent evidence highlights a multidisciplinary shift toward orbit-preserving, function-sparing strategies. Induction chemotherapy and immune checkpoint inhibitors can reduce tumor volume and expand eligibility for orbit-preserving surgery. Advances in endoscopic techniques now safely address select patterns of invasion, while modern radiation modalities improve local control with reduced toxicity. Together, these developments support individualized multimodal protocols that balance oncologic clearance with organ preservation.

Summary

Oncologic outcomes are driven more by tumor histology and depth and pattern of orbital invasion than by orbital sacrifice itself. In well-selected patients, coordinated use of systemic therapy, advanced surgery, and conformal radiation permits orbit preservation with survival comparable to exenteration, reserving orbital sacrifice for extensive patterns of invasion or pre-treatment dysfunction.