Surgical and prosthetic considerations in the management of orbital tumors

Since tumors of the globe and ocular adnexa, other than skin cancers of the eyelid, are uncommon, most oncologic specialists have little opportunity to become experienced in the management of eye tumors. In general, a malignancy that does not penetrate a bony orbital wall can be resected with an adequate margin by inclusion of the adjacent wall and periorbita. The decision to save or sacrifice a globe when a malignancy penetrates the bone but not the periorbita should be based on such factors as the tumor histology, contralateral vision, the probability of permanent diplopia, and the need for irradiation in doses that would destroy vision. Because of the complications involved with irradiation of orbital tumors, surgical resection has been the treatment of choice. In addition, orbital exenteration presents a unique challenge to the maxillofacial prosthodontist. Prosthetic restoration of the orbit is often complicated by the extent of resection, tissue response, and method of retention.