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“Push–Pull Technique” for the Management of a Selected Superomedial Intraorbital Lesion
22 February 2018
16 May 2018
20 June 2018 (online)
Orbital lesions are traditionally managed through external approaches when laterally located, and through a transnasal approach or other external approaches when medially located. However, when the lesion is superomedially located, it may determine a technical challenge.
In this study, we present the case of a patient with a superomedial intraconal venous malformation of the left eye. We addressed the mass through a combined approach, using the transnasal route as the main approach, and the superior eyelid approach to push down the lesion to facilitate the excision. We have called this approach “push–pull technique.”
We achieved a complete resection of the lesion and did not observe any intraoperative or postoperative complications. The last follow-up at 6 months postoperatively showed no recurrence, and the patient was satisfied and completely recovered.
According to our experience, the “push–pull” technique seems to be a safe procedure and might be considered a valid alternative to address selected superomedial intraconal lesions.
- 1 Dallan I, Castelnuovo P, Turri-Zanoni M. , et al. Transorbital endoscopic assisted management of intraorbital lesions: lessons learned from our first 9 cases. Rhinology 2016; 54 (03) 247-253
- 2 Markiewicz MR, Bell RB. Traditional and contemporary surgical approaches to the orbit. Oral Maxillofac Surg Clin North Am 2012; 24 (04) 573-607
- 3 Khan AM, Varvares MA. Traditional approaches to the orbit. Otolaryngol Clin North Am 2006; 39 (05) 895-909 , vi
- 4 Dallan I, Castelnuovo P, Sellari-Franceschini S, Locatelli D. Endoscopic Orbital and Transorbital Approaches. Tuttlingen, Germany: EndoPress GmbH; 2015
- 5 Castelnuovo P, Dallan I, Locatelli D. , et al. Endoscopic transnasal intraorbital surgery: our experience with 16 cases. Eur Arch Otorhinolaryngol 2012; 269 (08) 1929-1935
- 6 Bleier BS, Castelnuovo P, Battaglia P. , et al. Endoscopic endonasal orbital cavernous hemangioma resection: global experience in techniques and outcomes. Int Forum Allergy Rhinol 2016; 6 (02) 156-161
- 7 McKinney KA, Snyderman CH, Carrau RL. , et al. Seeing the light: endoscopic endonasal intraconal orbital tumor surgery. Otolaryngol Head Neck Surg 2010; 143 (05) 699-701
- 8 Castelnuovo P, Turri-Zanoni M, Battaglia P, Locatelli D, Dallan I. Endoscopic endonasal management of orbital pathologies. Neurosurg Clin N Am 2015; 26 (03) 463-472
- 9 Leone Jr CR. Surgical approaches to the orbit. Ophthalmology 1979; 86 (05) 930-941
- 10 Paluzzi A, Gardner PA, Fernandez-Miranda JC. , et al. “Round-the-clock” surgical access to the orbit. J Neurol Surg B Skull Base 2015; 76 (01) 12-24