Endoscopic transnasal intraorbital surgery: our experience with 16 cases

Abstract

The objective of the study is to present our multicentric experience on intraorbital lesions managed by means of an endonasal endoscopic approach. The study design used was multi-institutional retrospective review. We collected data on 16 intraorbital medially-located lesions, all managed by means of an endonasal route, treated in four different skull base centers. We retrospectively reviewed the technical details, complications, histology, and general outcome. The endoscopic endonasal approach was effective in removing completely intraorbital extra-intraconal tumors in 8 cases, in performing biopsies for histological diagnosis in 6 intraorbital intraconal tumors, and in draining 1 extraconal abscess. No major complications were observed; in particular, there was no optic nerve damage. Minor, temporary complications (diplopia) were seen in 3 cases; only 2 patients experienced a permanent diplopia related to medial rectus muscle impairment, in 1 case associated with enophthalmos. Our preliminary multi-centric clinical experience suggests that medially located intraorbital lesions, and in particular the infero-medial ones, can be successfully and safely managed by such an approach. The well-known advantages of the endoscopic techniques, namely the lack of external scars, less bleeding, shorter hospital stay, and fewer complications, are confirmed.

Purely endoscopic trans-nasal management of orbital intraconal cavernous haemangiomas: a systematic review of the literature

“…Twelve papers were identified and included which contained patient data for 17 cases [5][6][7][8][9][10][11][12][13][14][15][16]. Six patients were male and eleven were female.…”

Endoscopic endonasal orbital cavernous hemangioma resection: global experience in techniques and outcomes

“…3,4 In subsequent years however, only a limited number of case series from highvolume institutions have been published, which report on a variety of orbital pathologies. [5][6][7][8][9][10] During the same period, the widespread proliferation of endoscopic skull-base surgery has been mirrored by a body of literature that has matured from technique papers to larger multicenter outcome studies. 11 A similar rigor must be applied to the endoscopic orbital literature in order to expand the knowledge base in this, still nascent, field.…”

The evolving role of the oculoplastic surgeon in skull base surgery

“…Endoscopic approaches to the orbit have gained popularity [27]. The transnasal route is limited by how lateral one can go in the orbit.…”