Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

Endonasal Endoscopic Approach for Primary and Secondary Orbital Lesions

Joel Caballero García, Iosmill Morales Pérez, Franklin Abreu Perdomo, Nélido Gonzáles Fernández and Adolfo Michel Giol Álvarez

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.