Endoscopic transnasal approach for orbital tumors: A report of four cases

Arai, Yasuhiro; Kawahara, Nobutaka; Yokoyama, Takaakira

doi:10.1016/j.anl.2015.10.009

Cited by 10 publications

(12 citation statements)

References 13 publications

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“…4 This is the most common approach used in the management of orbital tumors located inferior and medial to the optic nerve. 4,5 It requires complete sphenoethmoidectomy, partial middle turbinectomy, medial maxillectomy, transposition of nasolacrimal duct, lamina papyracea removed and periorbita incised horizontally. 4 Residual tumor may require frontozygomatic approach.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 It requires complete sphenoethmoidectomy, partial middle turbinectomy, medial maxillectomy, transposition of nasolacrimal duct, lamina papyracea removed and periorbita incised horizontally. 4 Residual tumor may require frontozygomatic approach. Transient diplopia and dyschromatopsia can result after resecting intraconal tumors by this approach.…”

Section: Discussionmentioning

confidence: 99%

“…Transient diplopia and dyschromatopsia can result after resecting intraconal tumors by this approach. 4 For tumors situated in lateral aspect of retrobulbar orbit, the working angle will be difficult and limited space for handling the instruments. 6 Ethmoidectomy exposes the orbit to nasal infections and affects the recovery of the patient.…”

Section: Discussionmentioning

confidence: 99%

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Infraorbital approach for retrobulbar orbital neurofibroma: a case report

Harshitha

Mohiyuddin

Supreeth

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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<p class="abstract">Retrobulbar orbital tumours are rare and treatment is challenging. These tumors include cavernous hemangioma, neurofibroma, A-V malformations, glioma etc. A variety of approaches have been used in resection of these tumours. The various approaches in literature include endoscopic transethmoidal and sphenoidal, lateral orbitotomy, transmaxillary infraorbital, and cranial and sub cranial approaches. Such tumours located inferior to the optic nerve can be reached through infraorbital approach avoiding traction on optic nerve or pressure on globe. We are reporting a retrobulbar orbital neurofibroma in a middle aged lady who presented with unilateral loss of vision, episodic giddiness, severe left sided headache, left orbital pain and epiphora on exposure to sunlight. MRI showed well defined 1.8×1.8×1.7 cm enhancing lobulated solid left intraorbital mass extending along the substance of inferior aspect of left optic nerve with mass effect. With transmaxillary infraorbital endoscope assisted approach, the retrobulbar tumor was exposed and enucleated. Floor of orbit was reconstructed with tensor fascia lata and nasal septal cartilage graft. The patient had uneventful recovery and immediate post operative visual acuity was perception of light and likely to improve further. Histopathology revealed neurofibroma. This case report highlights the advantages of infraorbital approach as it is a simple approach along the suture lines through the orbital floor with the help of endoscopic guidance. It has the advantages of avoiding traction on optic nerve or optic chiasma, no retraction of brain, no communication with cranial cavity, no pressure on globe and easy reconstruction of orbital floor.</p>

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Infraorbital approach for retrobulbar orbital neurofibroma: a case report

Harshitha

Mohiyuddin

Supreeth

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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“…In addition, either these combined approaches or the EEA are also suitable for cases of optic nerve decompression, medial abscesses, or massive intranasal invasion lesions. 22,23…”

Section: Approach Considerationsmentioning

confidence: 99%

Surgical Techniques and the Choice of Operative Approach for Cranioorbital Lesions

Huang

Cai

et al. 2019

J Neurol Surg B Skull Base

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Objectives Cranioorbital lesions present a great challenge for neurosurgeons and ophthalmologists. There is no consensus on the choice of surgical approach. The aims of this study were to investigate 49 cases of cranioorbital lesions and evaluate surgical approaches and outcomes. Patients and Methods A retrospective study was done on 49 patients (51 operations) from 2009 to 2018. Information about the lesion was used to decide whether the supraorbital eyebrow approach (SEA) or pterional approach (PA) was performed. Results Twenty-eight patients had surgical resection using SEA, 21 patients received PA, each group included one case of recurrence, who underwent reoperation via the same approach. SEA provided better cosmetic satisfaction, and a shorter incision than PA (p < 0.05). There was no significant difference in total resection rates, visual outcomes, recovery of ptosis, and other new surgical-related complications between SEA group and PA group (p > 0.05). Forty-nine cases of proptosis (94.1%, 49/51) were improved. Thirty-three patients (33/37, 89.2%) who underwent follow-up for longer than 12 weeks had a modified Rankin Scale (mRS) score ≤ 3. Conclusion Surgery is the preferred treatment for cranioorbital lesions, but total resection is difficult. SEA may be a more minimally invasive option for some more limited lesions superior to optic nerve. PA may be more reasonable for the lesion with obvious hyperostosis and more extensive lesions.

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“…However, techniques for more advanced endoscopic intraconal surgery in benign tumors and orbital preservation in malignant nasosinusal tumors are in their nascent stage [2][3][4][5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Endonasal Endoscopic Approach for Primary and Secondary Orbital Lesions

Garcia¹,

Pérez²,

Perdomo³

et al. 2017

J Clin Exp Ophthalmol

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Purpose: To describe the results of endonasal endoscopic resection for primary and secondary orbital lesions.Design: A retrospective cohort study was performed. Subjects:The clinical data of patients with primary and secondary orbital tumors who received treatment with endonasal endoscopic surgery from Agost 2016 to July 2017 in the Department of Head and Neck Surgery of the National Institute of Oncology and Radiobiology (Cuba) were analysed.Intervention: All surgeries were performed by using Karl Storz 00, 450 and 700, 4 mm diameter; 18 cm rod-lens rigid telescopes (Karl Storz and Co, Tuttlingen, Germany). Endonasal endoscopic transethmoidal route was the primary approach, and according to the tumor size, histology and location, a transantral route was aggregate. Main outcome measures:Demographic data, histology nature of the lesions, clinical presentation, surgical route, frozen section margins and complications relative to treatment were obtained. Grade of resection was measured.Results: From total of 12 patients that were interview, 7 were male and 5 female. Age range was 20-70 years and a mean age of 50.2 years. According to nature of the lesions, seven patients have malignant neoplasm and three patients have non-neoplasic disorders. Transethmoidal route was performed in 4 patients and transethmoidal/ transantral in 8 patients. Total resection was achieved in 11 patients (92%). Frozen section margins were negative in all patients. All patients experienced complete resolution of the presenting symptoms with no evidence of optic nerve injury. Two patients presented transient ophtalmoparesis. Conclusion:Endonasal endoscopic surgery is a safe, successful and minimally invasive technique for resecting extra-intraconal primary and secondary orbital tumors; especially those arise posterior to the ocular glove and inferomedially of optic nerve. There are some important key points to take account in order to prevent complications.

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Endoscopic transnasal approach for orbital tumors: A report of four cases

Cited by 10 publications

References 13 publications

Infraorbital approach for retrobulbar orbital neurofibroma: a case report

Infraorbital approach for retrobulbar orbital neurofibroma: a case report

Surgical Techniques and the Choice of Operative Approach for Cranioorbital Lesions

Endonasal Endoscopic Approach for Primary and Secondary Orbital Lesions

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