Multimodal approaches in the management of malignancies involving the orbit

Malignancies involving the orbit comprise heterogeneous pathologies with a variety of ophthalmic and otolaryngic presentations resulting from compression and destruction of native orbital contents. Surgical ablation with negative margins with adjuvant treatment remains a cornerstone for optimal oncologic control and successful operative outcomes. Historically, attempts at tumor extirpation were first performed by neurosurgeons via open craniotomies to access orbital contents. While these approaches remain a mainstay within the superolateral compartment, endoscopic techniques pioneered by otolaryngologists have emerged as a standard in managing inferomedial orbital tumors. Approaches to these tumors remain a multidisciplinary endeavor involving neurosurgeons, ophthalmologists and/or oculoplastic surgeons, as well as otolaryngology – head and neck surgeons. This article will review and illustrate modern approaches to the orbit with special attention given to commonly employed expanded endoscopic and open techniques.