Thankfully, most tumors of the orbit are benign. But many of these still need to be removed surgically as they cause increased pressure on the contents of the orbit including the eyeball, optic nerve (potentially causing loss of vision) and the muscles that move the eyeball (leading to doubling of vision or a very prominent appearing eye (so called proptosis).
For benign tumors, we can often use minimally invasive approaches removing some with a camera in the nose (endoscopic approach) for tumors on the medial (towards the nose) part of the orbit. For others, we can approach them through hidden incisions inside the eyelids or small incisions around the eyelids.
Malignant tumors of the orbit often will involve removal of some adjacent structures inside the eye socket including the occasionally the eyeball and eyeball muscles. This is required often to prevent the cancers from extending into the adjacent brain. Chemotherapy and radiation may, depending on the tumor type also is required.
Reconstruction is important for both function as well as cosmetic. Often times we will do flaps (moving tissue around from one area of the body to the orbit) to help protect the brain from the outside world. This may involve the local temporalis muscle or pericranial flap or transplant from another part of the body (which one is determined by the exact surgical defect left from surgery).
TEMPORALIS MUSCLE FLAP FOR RECONSTRUCTION OF SKULL BASE DEFECTS
HEAD AND NECK, FEBRUARY 2010:32(2):199-203
THE VERSATILE EXTENDED PERICRANIAL FLAP FOR CLOSURE OF SKULLBASE DEFECTS OTOLARYNGOLOGY HEAD AND NECK SURGERY, JUN 2004
At times, it is necessary to remove tumors that extend from the brain into the orbit or from the maxillary sinus or facial skin or nose into the orbit. Dr. Ducic and the team at The Head and Neck Cancer of Texas have had a tremendous volume of experience over the past twenty years and have described several novel techniques to address these tumors.
ORBITOZYGOMATIC RESECTION OF MENINGIOMAS OF THE ORBIT LARYNGOSCOPE, JAN 2004:114(1):164-170
EXTENDED ORBITOZYGOMATIC APPROACH TO THE SKULLBASE TO IMPROVE ACCESS TO THE CAVERNOUS SINUS AND OPTIC CHIASM OTOLARYNGOLOGY HEAD AND NECK SURGERY, MAY 2004
The exact approach and surgery needed will depend on the tumor size, type and location. We look forward to seeing you in consultation.