Abstract

Summary A logical approach to the management of advanced tumours in and about the orbit is described, and the relevant historical aspects are reviewed. The failure of radiotherapy, when cancer invades the bone, calls for radical surgical extirpation, which for safe and adequate execution demands a combined craniofacial operation. A simple anatomical classification of tumour site is proposed as a guide to operative approach. The essential step in repair is cover by well-vascularised full-thickness pedicle flaps which can, where necessary, provide a new fascial covering for exposed brain. The hinged nasal septal flap is a useful adjunct. Three cases are described to illustrate these principles.

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