Endoscopic‐assisted transorbital extended orbital exenteration: A multi‐institutional preclinical study

Background Sinonasal malignancies with orbital invasion have dismal prognosis even when treated with orbital exenteration (OE). Sugawara et al. developed a surgical strategy called “extended‐OE (EOE),” showing encouraging outcomes. We hypothesized that a similar resection is achievable under endosco...

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Published in:Head & neck 2024-09, Vol.46 (9), p.2327-2339
Main Authors: Roccuzzo, Giuseppe, Vyskocil, Erich, Hirtler, Lena, Kandathil, Sam Augustine, Peris‐Celda, Maria, Agosti, Edoardo, Kuan, Edward C., Wang, Eric W., Leong, Samuel, Sharma, Rishi, Borsetto, Daniele, Herman, Philippe, Vinciguerra, Alessandro, Verillaud, Benjamin, Bresson, Damien, Taboni, Stefano, Erovic, Boban M., Vural, Alperen, Dallan, Iacopo, Doglietto, Francesco, Schreiber, Alberto, Mattavelli, Davide, Rampinelli, Vittorio, Arosio, Alberto Daniele, Battaglia, Paolo, Valentini, Marco, Turri‐Zanoni, Mario, Pozzi, Fabio, Volpi, Luca, Bignami, Maurizio, Castelnuovo, Paolo, Nicolai, Piero, Ferrari, Marco
Format: Article
Language:English
Subjects:
extended orbital exenteration
Head & neck cancer
Malignancy
orbital apex dissection
orbital encroaching malignancies
preclinical cadaveric study
sinonasal malignant tumors
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Summary:Background Sinonasal malignancies with orbital invasion have dismal prognosis even when treated with orbital exenteration (OE). Sugawara et al. developed a surgical strategy called “extended‐OE (EOE),” showing encouraging outcomes. We hypothesized that a similar resection is achievable under endoscopic guidance through the exenterated orbit (endoscopic‐EOE). Methods The study was conducted in three institutions: University of Vienna; Mayo Clinic; University of Insubria; 48 orbital dissections were performed. A questionnaire was developed to evaluate feasibility and safety of each step, scoring from 1 to 10, (“impossible” to “easy,” and “high risk” to “low risk,” respectively), most likely complication(s) were hypothesized. Results The step‐by‐step technique is thoroughly described. The questionnaire was answered by 25 anterior skull base surgeons from six countries. Mean, median, range, and interquartile range of both feasibility and safety scores are reported. Conclusions Endoscopic‐EOE is a challenging but feasible procedure. Clinical validation is required to assess real‐life outcomes.
ISSN:1043-3074
1097-0347
1097-0347
DOI:10.1002/hed.27858