Orbital approaches for primary and secondary tumours

Background: Orbital tumours are uncommon and represent approximately only 3.5 - 4 % of ophthalmic disease. Most published articles report case report, comparative studies with small numbers of patients or non-comparative studies with limited statistical power to provide clear treatment and reconstructive recommendations. Purpose: This paper reports our experience in treating orbital tumours. In particular, we analyzed both epidemiology, histology, methods of treatment and follow up. Particular emphasis is laid on the complications and aesthetic results of the different surgical approaches. Method: A retrospective study was carried out of 152 patients with orbital masses treated at Head and Neck Surgery Department of the University Hospital of Modena between January 2001 and the end of March 2016. The follow-up period begins in 2001 and finish by the 31th of March 2015. The survival has been calculated according to Kaplan-Meyer method (using IBM SPSS Statistics 20). Discussion: The median survival was ninety-six months. The cumulative survival at 12 months was 88 %; it came to 78 % in 24 months. The cumulative survival at 5 aa (60 months ) was 77 %. The lowest survival was showed in patients treated with an extensive osteotomy or exenteration. This result, however, could not be linked to the surgical approach but it could be due to the poor prognosis of the more advanced tumours and to the intracranial lesions involvement. Patients undergoing extensive osteotomies presented the greatest number of complications : 25 % complained of diplopia , 10% a decrease of visual acuity and 15 % had lagophthalmos , in two cases with epiphora . Conclusion: Preserving the contents of the orbital cavity and function is often possible after radical excision. However, conservative purposes have not to impair the oncologic efficacy.