Wednesday, 4 January 2017

Orbital Involvement in Primary Paranasal Sinus Space Occupying Lesions

Orbit is an innocent bystander that is afflicted by lesions of the Paranasal Sinuses (PNS). Orbits share 3 walls with the sinuses, frontal sinuses on the supero-medial aspects of the orbits, ethmoid sinuses medially and maxillary sinuses inferiorly.

Paranasal Sinus Space
Between the ethmoids and the orbits, there is lamina papyraecea which is a very thin bone. Between the maxillary sinus and the floor of the orbit, the bone is weakened by the passage of the infraorbital nerve. The periorbita or the periosteum of the orbit is a tough structure that resists invasion by tumors.

Once the tumor transgresses this robust layer, it spreads to the orbital spaces easily due to lack of barriers that check tumor spread. There is also rich vascular communication between the sinuses and the orbit, which acts as a conduit for spread of infections and tumors. The last but not the least is the communication between the nasal cavity and the orbit through the Nasolacrimal Duct.

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