J Neurol Surg B Skull Base 2020; 81(04): 459-471
DOI: 10.1055/s-0040-1713900
Surgical Approaches to the Orbit
Review Article

Endoscopic Orbital and Periorbital Approaches in Minimally Disruptive Skull Base Surgery

Craig Miller
1   Department of Otolaryngology—Head and Neck Surgery, University of Washington, Seattle, Washington, United States
Randall Bly
1   Department of Otolaryngology—Head and Neck Surgery, University of Washington, Seattle, Washington, United States
2   Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, Washington, United States
Kris S. Moe
1   Department of Otolaryngology—Head and Neck Surgery, University of Washington, Seattle, Washington, United States
3   Department of Neurosurgery, University of Washington, Seattle, Washington, United States
› Author Affiliations


Endoscopic surgery of the orbit, periorbital region, and adjacent areas of the anterior and middle cranial fossae and brain has gained significant popularity over the last decade. These procedures are now being used at multiple institutions internationally with a success and safety record that has been demonstrated to be at par with or better than other techniques. The approaches provide minimally disruptive, scarless access to regions that previously required extensive open operations with significant retraction of critical neurovascular structures leading to prolonged morbidity and hospitalization.

This paper will describe the basic techniques of these approaches, how they can be used alone or in multiportal (para- and contraportal) technique and guide the reader to resources for further learning.

Publication History

Article published online:
24 August 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

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