Ophthalmic and orbital considerations in the evaluation of skull base malignancies

J Neurooncol. 2020 Dec;150(3):483-491. doi: 10.1007/s11060-020-03516-6. Epub 2020 May 2.


Introduction: The orbital contents, afferent and efferent visual pathways, and the cranial nerves involved in eye movement, corneal sensation and eyelid closure traverse the skull base, a region bounded by the intracranial cavity, the paranasal sinuses, and the deep spaces of the face and head. As such, tumors from above or below have potential to affect some aspect of the visual system.

Methods: We discuss here the clinical ophthalmologic and orbital considerations in the evaluation of patients with these tumors, as well as the ophthalmic sequelae of treatment with radiation or surgery (or both). And for the surgeon, we discuss the ophthalmic and orbital considerations in surgical planning, the role of the orbital surgeon in skull base surgery, and briefly discuss transorbital approaches to the skull base.

Results and conclusion: Ophthalmic and orbital dysfunction may be the main source of disability in patients with skull base malignancy; it is thus incumbent on those who manage patients with tumors of this region to be aware of the ophthalmic, neuro-ophthalmic and orbital manifestations, so as to best tailor therapy and monitor treatment outcomes.

Keywords: Neuro-ophthalmology; Neurosurgical ophthalmology; Ophthalmology; Orbit; Orbital surgery; Skull base; Skull base surgery; Skull base tumor.

Publication types

  • Review

MeSH terms

  • Animals
  • Eye / physiopathology*
  • Humans
  • Neurosurgical Procedures / methods*
  • Orbit / physiopathology*
  • Skull Base Neoplasms / pathology*
  • Skull Base Neoplasms / surgery