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Endoscopic approach for orbital apex lesions: case series and review of the literature

Published online by Cambridge University Press:  09 June 2022

R Shemesh Open the ORCID record for R Shemesh [Opens in a new window] ,
A Yakirevitch ,
A Abergel ,
I Leibovitch ,
G J Ben Simon  and
R Ben Cnaan
R Shemesh
Affiliation:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Goldschleger Eye Institute, Ramat Gan, Israel
A Yakirevitch*
Affiliation:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Otolaryngology – Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel
A Abergel
Affiliation:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Otolaryngology – Head and Neck Surgery, Tel Aviv, Israel
I Leibovitch
Affiliation:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel
G J Ben Simon
Affiliation:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Goldschleger Eye Institute, Ramat Gan, Israel
R Ben Cnaan
Affiliation:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
*
Author for correspondence: Dr A Yakirevitch, Department of Otolaryngology – Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer 52621, Israel E-mail: [email protected] Fax: +97 23 635 5324
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Abstract

Objective

The transnasal endoscopic approach may provide better visualisation and a safer approach to the orbital apex. This study presents a case series of orbital apex lesions managed by this approach.

Method

This study was an eight-year retrospective analysis of seven patients who were operated on for orbital apex lesions in two tertiary medical centres.

Results

Complete tumour removal was performed in three patients and partial removal was performed in four patients. Visual acuity improved in three patients, remained stable in one patient and decreased in the other two patients. The visual field improved in four patients and did not change in two patients. Complications included worse vision and visual fields in 28.6 per cent of patients and late enophthalmos (of −1.25 ± 4.6 mm) in 2 patients.

Conclusion

The transnasal approach to orbital apex lesions in selected cases may provide a rational alternative to transorbital surgery. Complete tumour removal should be weighed against the risk of damage to the optic nerve.

Keywords

Orbital NeoplasmsVascular MalformationsHemangiomaOptic NerveNeurilemmoma
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 4 , April 2023 , pp. 419 - 425
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

*

Equal contribution

Dr A Yakirevitch takes responsibility for the integrity of the content of the paper

References

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