Abstract
Objective The aim of this study was to describe our experience using the transorbital endoscopic
approach (TEA) in the frontal sinus and the step-by-step technique used.
Materials and Methods We reviewed the charts from adult patients who underwent management of frontal sinus
lesions with TEA performed from 2017 to 2022.
Results Seven patients underwent eight surgeries for frontal sinus lesions using TEA in combination
with the endoscopic transnasal approach (ETA), with the majority on the left side
(5/8, 62.5%). The average age was 53.9 years, with six male patients and one female
patient. Gross total resection (GTR) was achieved in all cases. The most common symptoms
leading to surgery were headaches or a sensation of pressure in the forehead (5/8,
62.5%), followed by a decreased sense of smell (3/8, 37.5%), diplopia (3/8, 37.5%),
proptosis (2/8, 20%), periorbital cellulitis (2/8, 20%), and decreased visual acuity
(1/8, 12.5%). The most common etiology in this case series was mucocele (5/8, 62.5%),
followed by osteoid osteoma (2/8, 20%), and inverted papilloma (1/8, 12.5%). The length
of stay in all cases was 1 day. The most common complication was mild and transitory
V1 numbness, which fully recovered after 6 months (5/8, 62.5%). The average follow-up
period was 24.6 months (range of 3–48 months).
Conclusion Transoral Endoscopic Approach (TEA) demonstrated being a valuable complement to ETA
approaches for treating frontal sinus lesions, especially in challenging regions.
The transorbital approach is feasible and can safely achieve GTR for a variety of
pathologies while effectively controlling symptoms and resulting in a 1-day hospital
stay.
Keywords
endoscopic - frontal sinus - functional endoscopic sinus surgery - minimally invasive
- mucocele - osteoid osteoma - transorbital
