Removal of an orbital apex hemangioma using an endoscopic transethmoidal approach: technical note.

Abstract:

OBJECTIVE:The posterior orbit contains a number of important and vulnerable structures, including the optic nerve, the ophthalmic artery and vein, and the ocular muscles and their motor nerves, which makes surgical access to the lesion in this region quite difficult. Transfrontal, transfrontal-ethmoidal, and transmaxillary procedures have the disadvantage of possible injuries to a number of nontumor structures, whereas an endoscopic transethmoidal approach is a minimally invasive surgery for the retrobulbar lesions. Retrobulbar cavernous hemangioma was successfully removed by a transethmoidal approach. METHODS:Tumor removal was performed in a patient with an intraconal cavernous hemangioma of approximately 15 mm in diameter. By a transethmoidal approach, the medial-inferior part of the orbit, as well as the apex of the orbit, were clearly visualized after endonasal ethmoidectomy. After the removal of the medial orbital bone, the orbital periosteum was incised and elevated. By elevating the orbital fat, the tumor could be identified separately from the orbital contents. RESULTS:Cavernous hemangioma at the orbital apex was removed without complications. CONCLUSION:An endoscopic transethmoidal approach, which requires no skin incision, is a minimally invasive surgery for retrobulbar orbital tumor, leading to excellent cosmetic results with less bleeding.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Karaki M,Kobayashi R,Mori N

doi

10.1227/01.NEU.0000220027.49155.80

subject

Has Abstract

pub_date

2006-07-01 00:00:00

pages

ONSE159-60; discussion ONSE159-60

issue

1 Suppl 1

eissn

0148-396X

issn

1524-4040

pii

00006123-200607001-00023

journal_volume

59

pub_type

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