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World J Clin Cases. Mar 16, 2015; 3(3): 270-274
Published online Mar 16, 2015. doi: 10.12998/wjcc.v3.i3.270
Endoscopic treatment of orbital tumors
Francesco Signorelli, Carmelo Anile, Mario Rigante, Gaetano Paludetti, Angelo Pompucci, Annunziato Mangiola
Francesco Signorelli, Carmelo Anile, Angelo Pompucci, Annunziato Mangiola, Department of Neurosurgery, Catholic University School of Medicine, 00168 Rome, Italy
Mario Rigante, Gaetano Paludetti, Department of Otolaryngology, Catholic University School of Medicine, 00168 Rome, Italy
Author contributions: Signorelli F reviewed the literature and wrote the paper; Anile C and Rigante M implemented the discussion; Paludetti G and Pompucci A supervised the paper; Mangiola A designed the study and revised the manuscript.
Conflict-of-interest: There is no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Francesco Signorelli, MD, Department of Neurosurgery, Catholic University School of Medicine, Largo Agostino Gemelli, 8, 00168 Rome, Italy. francesco.signorelli1984@gmail.com
Telephone: +39-06-30154120 Fax: +39-06-3051343
Received: July 8, 2014
Peer-review started: July 9, 2014
First decision: August 28, 2014
Revised: November 24, 2014
Accepted: December 16, 2014
Article in press: December 19, 2014
Published online: March 16, 2015
Abstract

Different orbital and transcranial approaches are performed in order to manage orbital tumors, depending on the location and size of the lesion within the orbit. These approaches provide a satisfactory view of the superior and lateral aspects of the orbit and the optic canal but involve risks associated with their invasiveness because they require significant displacement of orbital structures. In addition, external approaches to intraconal lesions may also require deinsertion of extraocular muscles, with subsequent impact on extraocular mobility. Recently, minimally invasive techniques have been proposed as valid alternative to external approaches for selected orbital lesions. Among them, transnasal endoscopic approaches, “pure” or combined with external approaches, have been reported, especially for intraconal lesions located inferiorly and medially to the optic nerve. The avoidance of muscle detachment and the shortness of the surgical intraorbital trajectory makes endoscopic approach less invasive, thus minimizing tissue damage. Endoscopic surgery decreases the recovery time and improves the cosmetic outcome not requiring skin incisions. The purpose of this study is to review and discuss the current surgical techniques for orbital tumors removal, focusing on endoscopic approaches to the orbit and outlining the key anatomic principles to follow for safe tumor resection.

Keywords: Orbit, Orbital tumor, Endoscopy, Surgery, Approach

Core tip: Recently, minimally invasive techniques have been proposed as valid alternative to external orbital and transcranial approaches for selected orbital lesions. Among them, transnasal endoscopic approaches, “pure” or combined with external approaches, have been reported, especially for intraconal lesions located inferiorly and medially to the optic nerve. Herein we review and discuss the current surgical techniques for orbital tumors removal, focusing on endoscopic approaches to the orbit and outlining the key anatomic principles to follow for safe tumor resection.