Endoscopic Endonasal Transethmoidal Inferomedial Orbitotomy and En Bloc Excision of an Intraorbital Intraconal Cavernous Hemangioma: 2-Dimensional Operative Video

Abstract

Orbital cavernous hemangiomas (OCHs) are well encapsulated vascular lesions. They are amenable to dissection off the surroundings because they do not infiltrate the surrounding tissues. They are the third most common intraorbital lesion in the adult following lymphoid tumors and idiopathic orbital inflammation. 1-3 A spread pattern of contrast enhancement on dynamic CT or MRI favours OCHs. 4 An elderly lady presented with a history of protrusion of the right eye ball since 2 to 3 months. She also complained of increased tearing since 2 to 3 weeks. There was no history of diplopia or visual deterioration. Imaging revealed an intraconal lesion in the right eye which was inferomedial to the optic nerve. In view of the location, an endonasal transethmoidal approach was deemed most suitable. 5 We present a 2 dimensional video of the same. Informed consent was secured from the patient. The participants and any identifiable individuals consented to publication of his/her image. Histopathological examination revealed a cavernous hemangioma. Recovery was uneventful with complete resolution of proptosis.