Indications and Limitations of Endoscopic Endonasal Orbitotomy for Orbital Lesion

Abstract

Endoscopic endonasal surgical techniques have developed tremendously in the last 20 years. Endoscopic techniques have been applied to the treatment of cranial base lesions, pituitary tumors, orbital lesions, pterygopalatine fossa lesions, infratemporal fossa lesions, posterior cranial fossa lesions, and clival lesions. In some reports, endoscopic endonasal transparanasal orbitotomies have been indicated for lesions localized to the medial and inferomedial parts of the orbit. The aim of this article was to present the technique of endoscopic endonasal orbitotomy (EEO) for orbital extraperiosteal and intraperiosteal lesions, as well as its indications and limitations. We present cases of 4 patients who underwent EEO for typical extraperiosteal and intraperiosteal orbital lesions. We examined the indications and limitations in each case. All 4 orbital lesions were completely removed by EEO with no major complications. The EEO procedure, which does not require a skin incision, is a minimally invasive surgery used for treating orbital retrobulbar lesions. It leads to excellent cosmetic results with little bleeding. In the future, we need to determine its operative indications, safety, and dangers. It is necessary for us to further improve this surgical technique to allow for the generalization of the procedure.