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Endoscopic transorbital approach: indications and limits
EANS Academy. Zoia C. 09/25/19; 275448; EP04110
Dr. Cesare Zoia
Dr. Cesare Zoia

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Abstract
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Background: Recently, the endoscopic approach to the orbit has been proposed as an alternative to the traditional ones for the treatment of selected pathologies located in the lateral quadrants. The transorbital approach has been also proposed to remove intracranial lesions of the middle cranial fossa or, in general, lesions involving the greater wing of the sphenoid.
Methods: We performed a retrospective analysis on the patients that were operated with an endoscopic transorbital approach at our center from January 2016 to November 2018. Our aim is to analyze the indications, results and limits of the endoscopic transorbital approach.
Results: Sixteen patients met the inclusion criteria: seven cases were of spheno-orbital meningiomas, the other were one foreing body, five biopsy of orbital lesions, one metastasis of a poorly differentiated carcinoma, one metastasis of a squamous cell carcinoma and one fibromixoid sarcoma. All cases but one had good results in terms of surgical outcome and patient satisfaction, with a reduction of the hospital stay compared to our previous data with open surgery. We report one complication: a brain abscess one month after surgery treated with open surgical field debridement and antibiotic therapy.
Conclusions: The endoscopic transorbital approach could be a suitable alternative to standard approaches in cases of orbital lesions and in very selected cases of lesions with extention to the sphenoid bone or to the middle cranial fossa.
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