Sinonasal tumors with orbital involvement: the combined approach

Advanced sinonasal tumors often present with orbital involvement. Surgical treatment and radical excision are also possible preserving the eye. Oncological safety and functional outcome of preserved eye are the counterpart in orbital preservation surgery. Irrespectively of the orbital invasion, tumor histology influences the prognosis. Surgical approaches to the orbit in sinonasal tumor are divided in anterior and posterolateral procedures. The combined transfacial and trancranial surgical approach have been well described in the literature for craniofacial resection, when the anterior or medium skull base are involved. Multidisciplinary collaboration with microscopic and/or endoscopic control have improved surgical technique to extirpate tumors extended to dura, spehenopalatine area and pterygomaxilmary fissure, infratemporal fossa, roof of nasopharynx and apex of orbit. We describe the multiphase combined surgical approach whit maxillofacial, otolaryngology and neurosurgical collaboration in sinonasal tumor treatment.