J Neurol Surg B Skull Base 2020; 81(04): 409-421
DOI: 10.1055/s-0040-1713893
Surgical Approaches to the Orbit
Review Article

Surgery around the Orbit: How to Select an Approach

Davide Locatelli
1   Division of Neurosurgery, Department of Biotechnology and Life Sciences, “Ospedale di Circolo e Fondazione Macchi,” University of Insubria, Varese, Italy
,
Iacopo Dallan
2   Department of Otorhinolaryngology Azienda Ospedaliera Universitaria, Pisa, Italy
,
Paolo Castelnuovo
3   Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, “Ospedale di Circolo e Fondazione Macchi,” University of Insubria, Varese, Italy
› Author Affiliations

Abstract

Orbital region pathologies may be safely and effectively treated through a various number of approaches. As the concept of “outcome” and minimally invasive surgery keeps gaining popularity in neurosurgery, these approaches—each with specific indications and limitations—together provide the best surgical options.



Publication History

Article published online:
21 September 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

 
  • References

  • 1 Moe KS, Bergeron CM, Ellenbogen RG. Transorbital neuroendoscopic surgery. Neurosurgery 2010; 67 (3, Suppl Operative): ons16-ons28
  • 2 Locatelli D, Pozzi F, Turri-Zanoni M. et al. Transorbital endoscopic approaches to the skull base: current concepts and future perspectives. J Neurosurg Sci 2016; 60 (04) 514-525
  • 3 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
  • 4 Dallan I, Castelnuovo P, Sellari-Franceschini S, Locatelli D. Endoscopic Orbital and Transorbital Approaches. Tuttingler, Germany: EndoPress GmbH; 2015. . Available at: https://www.karlstorz.com/cps/rde/xbcr/karlstorz_assets/ASSETS/3444871.pdf
  • 5 Mann WJ, Kahaly GJ, Pitz S. et al. Decompression surgery for thyroid-associated orbitopathy–a ten year experience. Exp Clin Endocrinol Diabetes 1999; 107 (Suppl. 05) S212-S213
  • 6 Garrity JA, Henderson JW, Cameron JD. Henderson's Orbital Tumors. Google Books. 4th edition. Philadelphia, PA: Lippincott Williams & Wilkins; doi:2006011323
  • 7 Kloos R, Mourits D, Saeed P, Mourits M. Orbital apex cavernous hemangioma–beware of the pear!. Acta Ophthalmol 2013; 91 (04) e328-e329
  • 8 Peron S, Cividini A, Santi L, Galante N, Castelnuovo P, Locatelli D. Spheno-orbital meningiomas: when the endoscopic approach is better. Acta Neurochir Suppl 2017; 124: 123-128
  • 9 Dallan I, Sellari-Franceschini S, Turri-Zanoni M. et al. Endoscopic transorbital superior eyelid approach for the management of selected spheno-orbital meningiomas: preliminary experience. OperNeurosurg (Hagerstown) 2018; 14 (03) 243-251
  • 10 Dallan I, Castelnuovo P, Locatelli D. et al. Multiportal combined transorbital transnasal endoscopic approach for the management of selected skull base lesions: preliminary experience. World Neurosurg 2015; 84 (01) 97-107
  • 11 Castelnuovo P, Pistochini A, Locatelli D. Different surgical approaches to the sellar region: focusing on the “two nostrils four hands technique”. Rhinology 2006; 44 (01) 2-7
  • 12 Di Somma A, Andaluz N, Cavallo LM. et al. Endoscopic transorbital superior eyelid approach: anatomical study from a neurosurgical perspective. J Neurosurg 2018; 129 (05) 1203-1216
  • 13 Chen HI, Bohman LE, Loevner LA, Lucas TH. Transorbital endoscopic amygdalohippocampectomy: a feasibility investigation. J Neurosurg 2014; 120 (06) 1428-1436
  • 14 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
  • 15 Signorelli F, Anile C, Rigante M, Paludetti G, Pompucci A, Mangiola A. Endoscopic treatment of orbital tumors. World J Clin Cases 2015; 3 (03) 270-274
  • 16 Castelnuovo P, Arosio AD, Volpi L. et al. Endoscopic transnasal cryo-assisted removal of orbital cavernous hemangiomas: case report and technical hints. World Neurosurg 2019; 126: 66-71
  • 17 Rosen N, Priel A, Simon GJB, Rosner M. Cryo-assisted anterior approach for surgery of retroocular orbital tumours avoids the need for lateral or transcranial orbitotomy in most cases. Acta Ophthalmol 2010; 88 (06) 675-680
  • 18 Dallan I, Locatelli D, Turri-Zanoni M. et al. Transorbital endoscopic assisted resection of a superior orbital fissure cavernous haemangioma: a technical case report. Eur Arch Otorhinolaryngol 2015; 272 (12) 3851-3856
  • 19 Karligkiotis A, Appiani MC, Verillaud B, Herman P. How to prevent diplopia in endoscopic transnasal resection of tumors involving the medial orbital wall. Laryngoscope 2014; 124 (09) 2017-2020
  • 20 Nicolai P, Battaglia P, Bignami M. et al. Endoscopic surgery for malignant tumors of the sinonasal tract and adjacent skull base: a 10-year experience. Am J Rhinol 2008; 22 (03) 308-316
  • 21 Castelnuovo P, Dallan I, Locatelli D. et al. Endoscopic transnasalintraorbital surgery: our experience with 16 cases. Eur Arch Otorhinolaryngol 2012; 269 (08) 1929-1935
  • 22 Wright JE, Arden G, Jones BR. Continuous monitoring of the visually evoked response during intra-orbital surgery. Trans Ophthalmol Soc U K 1973; 93 (00) 311-314
  • 23 Chacko AG, Babu KS, Chandy MJ. Value of visual evoked potential monitoring during trans-sphenoidal pituitary surgery. Br J Neurosurg 1996; 10 (03) 275-278
  • 24 Wiedemayer H, Fauser B, Armbruster W, Gasser T, Stolke D. Visual evoked potentials for intraoperative neurophysiologic monitoring using total intravenous anesthesia. J NeurosurgAnesthesiol 2003; 15 (01) 19-24
  • 25 Karaki M, Kobayashi R, Mori N. Removal of an orbital apex hemangioma using an endoscopic transethmoidal approach: technical note. Neurosurgery 2006; 59 (01) (Suppl. 01) E159-E160 , discussion E159–E160
  • 26 Chhabra N, Wu AW, Fay A, Metson R. Endoscopic resection of orbital hemangiomas. Int Forum Allergy Rhinol 2014; 4 (03) 251-255
  • 27 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
  • 28 Stokken J, Gumber D, Antisdel J, Sindwani R. Endoscopic surgery of the orbital apex: Outcomes and emerging techniques. Laryngoscope 2016; 126 (01) 20-24
  • 29 Tan SH, Prepageran N. Endoscopic transnasal approach to medial orbital lesions. J LaryngolOtol 2015; 129 (09) 928-931
  • 30 Bleier BS, Healy Jr DY, Chhabra N, Freitag S. Compartmental endoscopic surgical anatomy of the medial intraconal orbital space. Int Forum Allergy Rhinol 2014; 4 (07) 587-591
  • 31 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
  • 32 Felippu A, Mora R, Guastini L, Peretti G. Transnasal approach to the orbital apex and cavernous sinus. Ann OtolRhinolLaryngol 2013; 122 (04) 254-262
  • 33 Tomazic PV, Stammberger H, Habermann W. et al. Intraoperative medialization of medial rectus muscle as a new endoscopic technique for approaching intraconal lesions. Am J Rhinol Allergy 2011; 25 (05) 363-367
  • 34 Ikonomidis C, Hamedani M, Pasche P. Endoscopic transethmoidal approach for removal of intraconal hemangiomas using an autostatic retractor for exposure–technical note. Clin Otolaryngol 2015; 40 (01) 72-74
  • 35 Dallan I, Castelnuovo P, De Notaris M. et al. Endoscopic endonasal anatomy of superior orbital fissure and orbital apex regions: critical considerations for clinical applications. Eur Arch Oto-Rhino-Laryngology 2013; DOI: 10.1007/s00405-012-2281-3.
  • 36 Turvey TA, Golden BA. Orbital anatomy for the surgeon. Oral Maxillofac Surg Clin North Am 2012; 24 (04) 525-536
  • 37 Chen HI, Bohman LE, Emery L. et al. Lateral transorbital endoscopic access to the hippocampus, amygdala, and entorhinal cortex: initial clinical experience. ORL 2015; DOI: 10.1159/000438762.
  • 38 Sieskiewicz A, Lyson T, Mariak Z, Rogowski M. Endoscopic trans-nasal approach for biopsy of orbital tumours using image-guided neuro-navigation system. Acta Neurochir (Wien) 2008; 150 (05) 441-445 , discussion 445
  • 39 Healy Jr DY, Lee NG, Freitag SK, Bleier BS. Endoscopic bimanual approach to an intraconal cavernous hemangioma of the orbital apex with vascularized flap reconstruction. OphthalPlastReconstr Surg 2014; 30 (04) e104-e106
  • 40 Colletti G, Pipolo C, Lozza P. et al. Orbital medial wall fractures: purely endoscopic endonasal repair with polyethylene implants. Clin Otolaryngol 2018; 43 (01) 396-398
  • 41 McCormick J, Allen M, Kain JJ. et al. Lateral nasal wall extension of the nasoseptal flap for skull-base and medial orbital wall defects. Int Forum Allergy Rhinol 2019; 9 (09) 1041-1045
  • 42 Chhabra N, Healy DY, Freitag SK, Bleier BS. The nasoseptal flap for reconstruction of the medial and inferior orbit. Int Forum Allergy Rhinol 2014; 4 (09) 763-766
  • 43 Bleier BS, Kohman RE, Feldman RE, Ramanlal S, Han X. Permeabilization of the blood-brain barrier via mucosal engrafting: implications for drug delivery to the brain. PLoS One 2013; 8 (04) e61694
  • 44 Bleier BS. Regional expression of epithelial MDR1/P-glycoprotein in chronic rhinosinusitis with and without nasal polyposis. Int Forum Allergy Rhinol 2012; 2 (02) 122-125
  • 45 Virgin FW, Bleier BS, Woodworth BA. Evolving materials and techniques for endoscopic sinus surgery. Otolaryngol Clin North Am 2010; 43 (03) 653-672 , xi
  • 46 Wang EW, Zanation AM, Gardner PA. et al. ICAR: endoscopic skull-base surgery. Int Forum Allergy Rhinol 2019; 9 (S3): S145-S365
  • 47 Bleier BS. A shift in the orbit: immediate endoscopic reconstruction after transnasal orbital tumors resection: Response. J Craniofac Surg 2018; 29 (06) 1674-1675
  • 48 Alqahtani AA, Dallan I, Castelnuovo P. Transorbital transnasal endoscopic combined approach to anterior and middle skull base: laboratory investigation. Otolaryngol Neck Surg 2014; 151 (1_suppl): P130-P130