Traditional Approaches to the Orbit

Khan, Aayesha M.; Varvares, Mark A.

doi:10.1016/j.otc.2006.08.008

Cited by 44 publications

(34 citation statements)

References 24 publications

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“…The experience of the surgeon is usually another critical factor that influences the choice of the surgical approach. As a whole, different approaches to medial retrobulbar spaces have been described [3], with the orbitotomic and transconjunctival ones probably the best known. As an alternative, transnasal procedures seem to offer a direct and effective route to the medial orbital spaces.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, it is well known that external approaches to lesions of the medial compartment of the orbit require significant displacement of orbital structures including the globe, or even muscle detachment [3]. The absence of needing muscle detachment and the shortness of the surgical intraorbital trajectory represent major advantages over traditional anterior approaches.…”

Section: Discussionmentioning

confidence: 99%

“…Among transnasal corridors, the transorbital one represents a valuable solution to manage the medial portion of the orbital spaces. Depending on tumor localization within the orbit, different kinds of external approaches (either transconjunctival or transcutaneous or even transcranial) have been proposed [3]. More in detail, medial intraorbital lesions can be addressed by means of different approaches, often requiring one or more orbitotomy and/or muscle detachment.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic transnasal intraorbital surgery: our experience with 16 cases

Castelnuovo

Dallan

Locatelli

et al. 2012

Eur Arch Otorhinolaryngol

109

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The objective of the study is to present our multicentric experience on intraorbital lesions managed by means of an endonasal endoscopic approach. The study design used was multi-institutional retrospective review. We collected data on 16 intraorbital medially-located lesions, all managed by means of an endonasal route, treated in four different skull base centers. We retrospectively reviewed the technical details, complications, histology, and general outcome. The endoscopic endonasal approach was effective in removing completely intraorbital extra-intraconal tumors in 8 cases, in performing biopsies for histological diagnosis in 6 intraorbital intraconal tumors, and in draining 1 extraconal abscess. No major complications were observed; in particular, there was no optic nerve damage. Minor, temporary complications (diplopia) were seen in 3 cases; only 2 patients experienced a permanent diplopia related to medial rectus muscle impairment, in 1 case associated with enophthalmos. Our preliminary multi-centric clinical experience suggests that medially located intraorbital lesions, and in particular the infero-medial ones, can be successfully and safely managed by such an approach. The well-known advantages of the endoscopic techniques, namely the lack of external scars, less bleeding, shorter hospital stay, and fewer complications, are confirmed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic transnasal intraorbital surgery: our experience with 16 cases

Castelnuovo

Dallan

Locatelli

et al. 2012

Eur Arch Otorhinolaryngol

109

View full text Add to dashboard Cite

show abstract

“…Extraocular muscles (EOM) are important reference points in surgery and represent the most frequent site of surgical manipulation for the treatment of strabismus (Khan & Varvares, 2006;Salem & Qahtani, 2001;Porter et al, 1995). The classic anatomy literature describes the origin of the rectus muscles (superior: SR, inferior: IR, medial: MR and lateral: LR) at the annulus of Zinn, the levator muscle of the upper eyelid (LM), the superior oblique (SO) at the lesser wing of the sphenoid and the inferior oblique (IO) at the anteroinferior portion of the medial wall of the orbit.…”

Section: Introductionmentioning

confidence: 99%

A Morphometric Study of the Extraocular Muscles

Villarreal-Silva¹,

Hinojosa-Amaya²,

Cruz³

et al. 2013

Int. J. Morphol.

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SUMMARY: Extraocular muscles are important references in strabismus surgery and in placement of intraorbital devices. We analyzed extraocular muscles morphometry and possible anatomical variances of 20 orbits. We report the length, width, and points of insertion of the extraocular muscles. No anatomical variations in length, width and points of insertion were found. With regard to the rectus muscles, it was found that the superior rectus and lateral rectus are the longest muscles and that the width difference between the superior and inferior rectus is greater than that between the medial and lateral rectus and that the point of insertion of the rectus muscles has a variable morphology. The superior oblique muscle was smaller in caliber than the inferior oblique, as consistent with previous anatomical studies. Knowledge of the detailed morphology of extraocular muscles is fundamental in strabismus surgery and represents a key factor for the innovation of surgical techniques and orbital procedures.

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“…The complications of external conventional approaches for orbital tumors include motility deficits (22.9%), ptosis (13.6%), visual deterioration (12.1%), etc. [26,27]. In this cohort only one patient suffer any complication (diplopia secondary to middle rectus muscle paresis) relative to surgical manipulation of these muscles due the adherent nature of the tumor (firm, adherent pseudotumor).…”

Section: Surgical Principles -Avoiding Complicationsmentioning

confidence: 87%

Endonasal Endoscopic Approach for Primary and Secondary Orbital Lesions

Garcia¹,

Pérez²,

Perdomo³

et al. 2017

J Clin Exp Ophthalmol

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Purpose: To describe the results of endonasal endoscopic resection for primary and secondary orbital lesions.Design: A retrospective cohort study was performed. Subjects:The clinical data of patients with primary and secondary orbital tumors who received treatment with endonasal endoscopic surgery from Agost 2016 to July 2017 in the Department of Head and Neck Surgery of the National Institute of Oncology and Radiobiology (Cuba) were analysed.Intervention: All surgeries were performed by using Karl Storz 00, 450 and 700, 4 mm diameter; 18 cm rod-lens rigid telescopes (Karl Storz and Co, Tuttlingen, Germany). Endonasal endoscopic transethmoidal route was the primary approach, and according to the tumor size, histology and location, a transantral route was aggregate. Main outcome measures:Demographic data, histology nature of the lesions, clinical presentation, surgical route, frozen section margins and complications relative to treatment were obtained. Grade of resection was measured.Results: From total of 12 patients that were interview, 7 were male and 5 female. Age range was 20-70 years and a mean age of 50.2 years. According to nature of the lesions, seven patients have malignant neoplasm and three patients have non-neoplasic disorders. Transethmoidal route was performed in 4 patients and transethmoidal/ transantral in 8 patients. Total resection was achieved in 11 patients (92%). Frozen section margins were negative in all patients. All patients experienced complete resolution of the presenting symptoms with no evidence of optic nerve injury. Two patients presented transient ophtalmoparesis. Conclusion:Endonasal endoscopic surgery is a safe, successful and minimally invasive technique for resecting extra-intraconal primary and secondary orbital tumors; especially those arise posterior to the ocular glove and inferomedially of optic nerve. There are some important key points to take account in order to prevent complications.

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Traditional Approaches to the Orbit

Cited by 44 publications

References 24 publications

Endoscopic transnasal intraorbital surgery: our experience with 16 cases

Endoscopic transnasal intraorbital surgery: our experience with 16 cases

A Morphometric Study of the Extraocular Muscles

Endonasal Endoscopic Approach for Primary and Secondary Orbital Lesions

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