Endoscopic Transnasal Resection of Solitary Fibrous Tumor in the Optic Canal

BackgroundThe Cavernous Hemangioma Exclusively Endonasal Resection CHEER classification system was developed to standardize prospective outcome analysis following orbital cavernous hemangioma OCH resection The goal of this study was to retroactively apply the CHEER system to all prior existing reports of endoscopic resection of primary benign orbital tumors BOTs to compare patient presentations perioperative characteristics and outcomes between OCH and other BOTs and determine whether the CHEER categorization regime could be expanded to other BOTs Methods A systematic review of studies reporting exclusively endoscopic resections of OCH and other BOTs eg solitary fibrous tumor schwannoma and meningioma was performed Patient tumor characteristics and operative outcomes were recorded All tumors with adequate reporting were retrospectively assigned a CHEER stage Outcomes were compared using chi-square or Fisher's exact tests Results Ninety-three studies met inclusion criteria and sufficient data were available in studies comprising tumors n =OCHs n = other BOTs Baseline patient and tumor characteristics as well as intraoperative and short-term postoperative outcomes were not signifi-cantly different between OCHs and other BOTs Long-term outcomes eg visual deficits diplopia eye position and recurrence also did not differ when controlling for CHEER stage Conclusion This review represents the largest collection of outcomes data following exclusively endoscopic endonasal resection of BOTs Short-term and long-term outcomes appear similar between OCHs and other BOTs These results suggest that exclusively endoscopic resection of orbital tumors may be effective in a range of benign pathologies Furthermore these results support a broader application of the CHEER system to other benign primary orbital tumors

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“…and A.E.L. ), a final list of articles was generated for data collection (see Supplementary Table 2) 1,3,7,8,17,20–50 …”

Section: Methodsmentioning

confidence: 99%

Exclusively endoscopic endonasal resection of benign orbital tumors: a systematic review and meta‐analysis

Jafari

Sneidern

Lehmann

et al. 2020

Int Forum Allergy Rhinol

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“…In the last 10 years, endoscopic resection of orbital tumors is increasingly common and has expanded to include more tumors than orbital cavernous venous malformations. Endoscopic resection of lymphangiomas, 31 meningiomas, [44][45][46] schwannomas, [47][48][49] fibrous dysplasia, 10,44 solitary fibrous tumors, 33,50 chordomas, chondrosarcomas, and metastatic carcinomas have been reported. 37 In a meta-analysis review comparing endoscopic resection of orbital cavernous venous malformations with other PBOTs, the short-term and long-term outcomes as measured by visual acuity deficits, diplopia, eye position, and recurrence rates are similar between groups when controlling for CHEER stage.…”

Section: Outcomes and Complicationsmentioning

confidence: 99%

Endonasal Endoscopic Approach to Orbital Tumors

Chiou

Vickery

Reshef

et al. 2023

International Ophthalmology Clinics

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The orbit is a quadrilateral pyramid-shaped bony cavity that houses various delicate structures, including the globe, extraocular muscles, cranial nerves II to VI, and blood vessels. The complex nature of this anatomy can pose a challenge to safe surgical access to the tumors located within the orbit. Traditional surgical management of these tumors utilizes external orbital approaches via conjunctival, caruncular, or cutaneous incisions and, depending on tumor characteristics, location, and size, may require zygomatic osteotomies or frontotemporal craniotomies. 1 The interfacing anatomy of the medial orbital wall and the sinonasal cavity sanctions surgical access to the orbit via an endonasal endoscopic approach (EEA), which has more recently become a valuable alternative in the management of orbital pathology.The initial use of this approach to the orbit was first described in 1990 by Kennedy et al 2 who reported a series of cases of endoscopic medial wall orbital decompressions for thyroid ophthalmopathy. This was followed by a precipitous adaptation of endoscopic endonasal surgery for other clinical indications, including optic nerve decompression, 3 orbital biopsies, 4 removal of foreign bodies, 5 repair of medial wall fractures, 6 among others; and indications for this approach have continued to broaden because of increased surgeon experience and advances in technology. The first reported excisions of orbital tumors, specifically cavernous venous malformations, via an

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