Tumori nasosinusali: il problema dell'invasione orbitaria.

Neoplasms of the nasal cavity and paranasal sinuses constitute less than 1% of all malignant tumors and account for 3% of those within the E.N.T. field. The course of said pathologies is characterized by scant lymph node metastases and by a marked tendency toward local evolution. Since symptoms are not particularly specific diagnosis is normally arrived at late (approximately 6 months after the first symptoms) when the disease is already in an advanced stage. The orbital area and its contents are quite difficult to study both from a clinical point of view and in terms of testing methodology. Orbital symptoms exist at onset in from 25-30% of the cases. On the other hand, when evaluated upon surgery, orbital invasion is encountered in 40% of the patients. Unfortunately radiology is not always able to provide all the information a surgeon requires in order to establish the proper approach. Although CT is able to provide information regarding extension of the lesion to the soft parts it is not equally able to confidently diagnose initial infiltrations into the bony walls of the orbita. A sampling of 31 patients with tumors of the nasal cavity and paranasal sinuses was studied. All subjects underwent careful radiological examination and were treated with a combination of surgery and radiotherapy. Upon clinical examination orbital invasion was suspected for 50% of the cases. Only in 40% of the cases did radiology confirm this while in 60% it was confirmed by surgery. It is worth noting that during surgery only half of the cases of such invasion were deemed as requiring orbitectomy.(ABSTRACT TRUNCATED AT 250 WORDS)