Resection of orbital apex lesions through transnasal endoscopic approach (a report of 18 cases)

Abstract

Objective To investigate the fcasibility and efficacy of resection of orbital apex lesions through transnasal endoscopic approach.Methods From January 2009 to June 2013,18 patients with orbital apex lesions were analyzed retrospectively,of which the main symptoms were proptosis and vision loss.In this series,6 cases were orbital foreign body,4 cavernous hemangioma,3 trans-nasal-orbital mucinous cyst,2 inflammatory pseudotumor,1 cholesteatoma,1 neurofibroma,and 1 fibrodysplasia.All the patients underwent operation through ethmoid sinus with endoscopic techniques into orbit or orbital apex.Results All the foreign bodies were taken out by one operation.4 cavernous hemangiomas in orbital apex were totally removed,in two of them the postoperative visions were improved and another two unchanged.In 8 trans-nasal-orbital tumors,4 were totally removed,3 partially removed,of which the proptosis and eyeball movement were improved.All the patients were followed-up from 3 months to 4 years.1 inflammatory pseudotumor recurred and was removed again.There was no recurrence in the rest of cases,and the symptoms were disappeared.Conclusions In carefully selected cases,the lesions in orbit and orbital apex could be removed feasibly through transnasal endoscopic approach. Key words: Endoscope; Skull base surgery; Orbital apex lesion