Surgical Approaches to Diseases of the Orbital Apex

Leone, Charles R.; Wissinger, John P.

doi:10.1016/s0161-6420(88)33174-x

Cited by 37 publications

(20 citation statements)

References 4 publications

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“…Other authors describe the possibility of treating posteriorly and medially located lesions by combining the anterior approach with a lateral orbitotomy [17][18][19]. According to them, the removal of the lateral orbital rim and wall allows the lateral displacement of the orbital content and permits access to the medial spaces.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic transnasal intraorbital surgery: our experience with 16 cases

Castelnuovo

Dallan

Locatelli

et al. 2012

Eur Arch Otorhinolaryngol

109

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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.

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Section: Discussionmentioning

confidence: 99%

Endoscopic transnasal intraorbital surgery: our experience with 16 cases

Castelnuovo

Dallan

Locatelli

et al. 2012

Eur Arch Otorhinolaryngol

109

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“…Interventions in the inferior lateral quadrant may require an adjunctive transmaxillary approach. The superior lateral quadrant is preferably approached via traditional (i.e., craniotomy‐based) approaches, which can provide increased procedural safety and excellent anatomic exposure and are more likely to spare visual acuity . Although the present study was able to demonstrate the approach to and exposure of the lateral structures of the orbital apex, this procedure is contraindicated in patients with preserved visual acuity due to the heightened risk of optic nerve injury.…”

Section: Discussionmentioning

confidence: 80%

“…Several surgical approaches to the orbital apex have been described, such as lateral orbitotomy, medial orbitotomy, and craniotomy, all of which are highly invasive and carry significant rates of morbidity . In addition, pathologies that are medial and inferior can be difficult or impossible to access via medial or anterior approaches.…”

Section: Introductionmentioning

confidence: 99%

Endonasal identification of the orbital apex

et al. 2015

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In the cadavers studied in this sample, the ethmoidal crest and choanal arch were relevant structures and exhibited consistent measurements. Spearman correlation coefficients were greater than 0.7, which is indicative of good correlation between measurements obtained in the skull halves of each cadaver. Comparison of the measurements obtained in different sides showed similar values, with no statistically significant differences in the distances between any of the proposed anatomic landmarks.

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“…[2] La utilización de esta técnica podría implicar un mayor grado de retracción cerebral, pero cuando es aplicada como Hassler y Eggert describieron, maniobras tales como el drilado extradural del ala menor del esfenoides, destechamiento de la fisura orbitaria superior y realización de la orbitotomía posterior sin exponer al NO al calor o vibración, proporciona una excelente exposición del área quirúrgica y protege el resultado funcional del paciente. [111213] Elegimos por lo tanto este abordaje para tratar este tipo de lesión.…”

Section: Discussionunclassified

Tratamiento Quirúrgico de los Meningiomas del Foramen Ýptico, Técnicay Resultados de una Serie de 18 Pacientes Surgical treatment of optic foraminal meningiomas, surgical technique and outcomes from a series of 18 patients

Goldschmidt¹,

Ajler²,

Campero³

et al. 2014

Surg Neurol Int

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Introducción:los meningiomas del foramen óptico producen un rápido deterioro de la función visual aún cuando su tamaño es pequeño, por eso su diagnóstico y manejo difiere del resto de los meningiomas clinoideos. El propósito de este estudio es presentar la técnica y los resultados de nuestro manejo quirúrgico de meningiomas foraminales (MF).Pacientes y Métodos:se llevó a cabo una revisión de las historias clínicas de 47 pacientes con meningiomas primarios intraorbitarios. Se realizaron 52 cirugías en los pacientes con MF. Se empleó una craneotomía fronto-orbitaria, seguida de una descompresión extradural del canal óptico, resección del componente intraorbitario y exploración intradural del nervio óptico.Resultados:de los 12 pacientes con MF que presentaban la visión conservada, la agudeza visual fue preservada en 7 casos, mejoró en 2, y empeoró en 3. En 18 pacientes, el principal síntoma fue exoftalmos y en 35 pacientes ceguera unilateral. Ocurrieron 6 recurrencias, 2 a 10 años después de la resección quirúrgica. Cinco de ellos fueron reoperados. Se indicó radioterapia después de la recurrencia en 3 pacientes.Conclusión:el manejo de los MF continúa siendo controvertido y frecuentemente se propone un tratamiento conservador. Basados en nuestros hallazgos de frecuente extensión intracraneal, proponemos realizar una resección total o subtotal del tumor, preservando el nervio óptico en pacientes con visión prequirúrgica conservada.

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Surgical Approaches to Diseases of the Orbital Apex

Cited by 37 publications

References 4 publications

Endoscopic transnasal intraorbital surgery: our experience with 16 cases

Endoscopic transnasal intraorbital surgery: our experience with 16 cases

Endonasal identification of the orbital apex

Tratamiento Quirúrgico de los Meningiomas del Foramen Ýptico, Técnicay Resultados de una Serie de 18 Pacientes Surgical treatment of optic foraminal meningiomas, surgical technique and outcomes from a series of 18 patients

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