2025 Poster Presentations
P013: ENDOSCOPIC APPROACHES TO THE ORBIT: TRANSNASAL AND TRANSORBITAL, A CASE SERIES
Cesare Zoia1; Giorgio Mantovani2; Elisabetta Peppucci1; Andrea Montalbetti1; Giogia Piras1; Roada Bucpapaj1; Pasquale De Bonis2; Fabio Pagella3; Giannatonio Spena4; 1Ospedale Moriggia Pelascini, Gravedona, Italy; 2University of Ferrara, Ferrara, Italy; 3University of Pavia, Pavia, Italy; 4IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
Introduction: traditionally, orbital pathologies requiring surgery have been treated through open approaches, with different techniques tailored to the lesion's location. Recently, minimally invasive endoscopic techniques, such as the Endoscopic Endonasal Approach (EEA) and the Endoscopic Transorbital Approach (ETA), have been introduced into orbital surgery. This study aims to present the combined experience of the Neurosurgical and Ear-Nose-Throat (ENT) Units in utilizing these endoscopic approaches for orbital pathologies.
Materials and Methods: we conducted a retrospective review of data from patients who underwent endoscopic orbital surgery at our institution between 2016 and 2021. Complications were evaluated using the Clavien-Dindo classification, and cosmetic outcomes were assessed with the Scar Cosmesis Assessment and Rating (SCAR) Scale.
Results: during the study period, 39 patients met the inclusion criteria. Depending on the orbital quadrant involved, lesions were approached either with EEA (15 patients) or ETA (20 patients). In three cases, a combination of endoscopic techniques and anterior orbitotomy was used, while one patient underwent a combined EEA and ETA approach. Procedures performed included orbital biopsy (9 cases), orbital decompression (6 cases), subtotal lesion resection (STR) (8 cases), and total lesion resection (GTR) (16 cases). Postoperative complications included diplopia (5.1%, with one case of permanent diplopia), trigeminal paraesthesia and dysesthesia (5.1%), palpebral edema (17.9%), and periorbital ecchymosis (7.7%). The average follow-up period was 21 months (range 2-63 months).
Conclusions: endoscopic approaches to the orbital compartments offer minimally invasive access to all areas of the orbit, with a low complication rate and favorable cosmetic outcomes.