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Abstract：
The purpose of this study was to determine the frequency and associated risk factors of orbital/periocular complications in patients with sinonasal tumour with orbital invasion managed with eye-sparing treatments.
A retrospective case series of patients with primary sinonasal tumour with orbital invasion from January 2008 to December 2018. Patient factors were compared between the following groups: (1)patients with orbital/periocular complications versus those who did not and (2) patients who needed secondary oculoplastic surgical procedures versus those who did not.
Out of 80 patients, 48 had eye-sparing surgery, 8 had orbital exenteration and 24 were managed non-surgically. The most common histology was squamous cell carcinoma (n=28, 35%). Among the eye-sparing treatment group, 51/72 patients experienced one or more orbital/periocular complication(s), with motility deficit (N=26, 36%) being the most frequent. Factors associated with higher risk of complications included tumour involving the orbital floor (p=0.019), clinical disease stage III/IV (p=0.038), maxillectomy (p=0.004), resection of the orbital floor (p=0.027) and cigarette smoking (p=0.041). Tumour involving the orbital floor had an OR of 3.9 (95% CI 1.3 to 11.6, p=0.016) in predicting orbital/periocular complication. In the eye-sparing surgery group, the most frequent secondary oculoplastic procedures was dacryocystorhinostomy (n=6, 13%). The use of a free flap in reconstruction had an OR of 8.2 (95% CI 2.1 to 31.8, p=0.002) in predicting need for secondary oculoplastic surgery.
Majority of patients with sinonasal tumours and secondary orbital invasion were managed with eye-sparing multidisciplinary treatments. Preservation of the eye can lead to reasonably good functional outcome despite expected orbital and periocular complications.
A retrospective case series of patients with primary sinonasal tumour with orbital invasion from January 2008 to December 2018. Patient factors were compared between the following groups: (1)patients with orbital/periocular complications versus those who did not and (2) patients who needed secondary oculoplastic surgical procedures versus those who did not.
Out of 80 patients, 48 had eye-sparing surgery, 8 had orbital exenteration and 24 were managed non-surgically. The most common histology was squamous cell carcinoma (n=28, 35%). Among the eye-sparing treatment group, 51/72 patients experienced one or more orbital/periocular complication(s), with motility deficit (N=26, 36%) being the most frequent. Factors associated with higher risk of complications included tumour involving the orbital floor (p=0.019), clinical disease stage III/IV (p=0.038), maxillectomy (p=0.004), resection of the orbital floor (p=0.027) and cigarette smoking (p=0.041). Tumour involving the orbital floor had an OR of 3.9 (95% CI 1.3 to 11.6, p=0.016) in predicting orbital/periocular complication. In the eye-sparing surgery group, the most frequent secondary oculoplastic procedures was dacryocystorhinostomy (n=6, 13%). The use of a free flap in reconstruction had an OR of 8.2 (95% CI 2.1 to 31.8, p=0.002) in predicting need for secondary oculoplastic surgery.
Majority of patients with sinonasal tumours and secondary orbital invasion were managed with eye-sparing multidisciplinary treatments. Preservation of the eye can lead to reasonably good functional outcome despite expected orbital and periocular complications.
摘要：
目的：本研究的目的是确定鼻腔鼻窦肿瘤伴眼眶侵犯患者眼眶/眼周并发症的发生率和相关危险因素。
方法：2008年1月至2018年12月的回顾性病例系列原发性鼻窦肿瘤伴眼眶侵犯。在以下各组之间比较了患者因素：（1）患有眼眶/眼周并发症的患者与未患有眼眶/眼周并发症的患者；（2）需要二次眼整形外科手术的患者与未患有眼眶/眼周并发症的患者。
结果：在80名患者中，48人进行了保留眼睛的手术，8例进行了眼眶切除术，24例进行了非手术治疗。最常见的组织学是鳞状细胞癌（n=28，35％）。在保留眼睛的治疗组中，51/72例患者经历了一个或多个眼眶/眼周并发症，运动赤字（N=26，36％）最常见。与较高并发症风险相关的因素包括累及眶底的肿瘤（p=0.019），临床疾病III/IV期（p=0.038），上颌骨切除术（p=0.004），切除眶底（p=0.027）和吸烟（p=0.041）。在预测眼眶/眼周并发症方面，涉及眼眶的肿瘤的OR为3.9（95％CI1.3至11.6，p=0.016）。在保留眼睛的手术组中，最常见的继发性眼增生手术是泪囊鼻腔吻合术(n=6,13%).在重建中使用游离皮瓣预测二次眼整形手术的需要时，OR为8.2（95％CI2.1至31.8，p=0.002）。
结论：大多数患有鼻腔鼻窦肿瘤和继发性眼眶侵犯的患者采用保留眼睛的多学科治疗。尽管存在预期的眼眶和眼周并发症，但保留眼睛仍可导致合理的良好功能结果。
方法：2008年1月至2018年12月的回顾性病例系列原发性鼻窦肿瘤伴眼眶侵犯。在以下各组之间比较了患者因素：（1）患有眼眶/眼周并发症的患者与未患有眼眶/眼周并发症的患者；（2）需要二次眼整形外科手术的患者与未患有眼眶/眼周并发症的患者。
结果：在80名患者中，48人进行了保留眼睛的手术，8例进行了眼眶切除术，24例进行了非手术治疗。最常见的组织学是鳞状细胞癌（n=28，35％）。在保留眼睛的治疗组中，51/72例患者经历了一个或多个眼眶/眼周并发症，运动赤字（N=26，36％）最常见。与较高并发症风险相关的因素包括累及眶底的肿瘤（p=0.019），临床疾病III/IV期（p=0.038），上颌骨切除术（p=0.004），切除眶底（p=0.027）和吸烟（p=0.041）。在预测眼眶/眼周并发症方面，涉及眼眶的肿瘤的OR为3.9（95％CI1.3至11.6，p=0.016）。在保留眼睛的手术组中，最常见的继发性眼增生手术是泪囊鼻腔吻合术(n=6,13%).在重建中使用游离皮瓣预测二次眼整形手术的需要时，OR为8.2（95％CI2.1至31.8，p=0.002）。
结论：大多数患有鼻腔鼻窦肿瘤和继发性眼眶侵犯的患者采用保留眼睛的多学科治疗。尽管存在预期的眼眶和眼周并发症，但保留眼睛仍可导致合理的良好功能结果。
