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Published in: European Archives of Oto-Rhino-Laryngology 12/2015

01-12-2015 | Case Report

Transorbital endoscopic assisted resection of a superior orbital fissure cavernous haemangioma: a technical case report

Authors: Iacopo Dallan, Davide Locatelli, Mario Turri-Zanoni, Paolo Battaglia, Davide Lepera, Nicola Galante, Stefano Sellari-Franceschini, Paolo Castelnuovo

Published in: European Archives of Oto-Rhino-Laryngology | Issue 12/2015

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Abstract

Objectives

Superior orbital fissure and orbital apex lesions are challenging to manage, regardless of the approach chosen, due to the potential morbidity. The objectives of this study are to describe an innovative, minimally invasive surgical approach addressing this critical area and to discuss its indications and outcomes.

Subject

A young patient presented with visual disturbances (reduction of color discrimination, central scotoma) and mild exophthalmos owing to the presence of a right orbital apex cavernous haemangioma with superior orbital fissure invasion.

Methods

The lesion was removed via a minimally invasive, neuronavigated, transorbital superior eyelid endoscopic-assisted approach.

Main outcome measures

Technical feasibility and safety, early and late complications, length of hospitalization time and follow-up data were collected and analyzed.

Results

The lesion was radically resected minimizing the surgical morbidity and hospitalization time for the patient and with encouraging functional and cosmetic outcomes. No recurrences were observed 1 year after surgery.

Conclusions

The endoscopic-assisted transorbital approach should be considered a safe and effective option that can be applied in the treatment of lesions affecting such complex anatomical regions, as it offers excellent visualization of the surgical field, acceptable sequelae and reduced morbidity in relation to the traditional transcranial/transfacial approaches. Further studies and larger case series are needed in order to validate the reproducibility and range of applications of this surgical technique.
Literature
1.
go back to reference Khan AM, Varvares MA (2006) Traditional approaches to the orbit. Otolaryngol Clin North Am 39:895–909CrossRefPubMed Khan AM, Varvares MA (2006) Traditional approaches to the orbit. Otolaryngol Clin North Am 39:895–909CrossRefPubMed
2.
go back to reference Stamm A, Nogueira JF (2009) Orbital cavernous hemangioma: transnasal endoscopic management. Otolaryngol Head Neck Surg 141(6):794–795CrossRefPubMed Stamm A, Nogueira JF (2009) Orbital cavernous hemangioma: transnasal endoscopic management. Otolaryngol Head Neck Surg 141(6):794–795CrossRefPubMed
3.
go back to reference Harris GJ (2010) Cavernous hemangioma of the orbital apex; pathogenetic considerations in surgical management. Am J Ophthalmol 150:764–773CrossRefPubMed Harris GJ (2010) Cavernous hemangioma of the orbital apex; pathogenetic considerations in surgical management. Am J Ophthalmol 150:764–773CrossRefPubMed
4.
go back to reference Kloos R, Mourits D, Saeed P, Mourits M (2013) Orbital apex cavernous haemangiomas: beware of the pear! Acta Ophthalmol 91(4):e328–e329CrossRefPubMed Kloos R, Mourits D, Saeed P, Mourits M (2013) Orbital apex cavernous haemangiomas: beware of the pear! Acta Ophthalmol 91(4):e328–e329CrossRefPubMed
5.
go back to reference Dallan I, Castelnuovo P, Sellari-Franceschini S (2014) Endoscopic surgery inside and around the orbit. Silver Book, Karl Storz, Tuttlingen, Germany (in press) Dallan I, Castelnuovo P, Sellari-Franceschini S (2014) Endoscopic surgery inside and around the orbit. Silver Book, Karl Storz, Tuttlingen, Germany (in press)
6.
go back to reference McNab AA, Wright JE (1989) Cavernous hemangiomas of the orbit. Aust N Z J Ophthalmol 17(4):337–345CrossRefPubMed McNab AA, Wright JE (1989) Cavernous hemangiomas of the orbit. Aust N Z J Ophthalmol 17(4):337–345CrossRefPubMed
7.
go back to reference Rootman J (2014) Orbital surgery: a conceptual approach, 2nd edn. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia Rootman J (2014) Orbital surgery: a conceptual approach, 2nd edn. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia
8.
go back to reference Dallan I, Castelnuovo P, de Notaris M et al (2013) Endoscopic endonasal anatomy of superior orbital fissure and orbital apex regions: critical considerations for clinical applications. Eur Arch Otorhinolaryngol 270(5):1643–1649CrossRefPubMed Dallan I, Castelnuovo P, de Notaris M et al (2013) Endoscopic endonasal anatomy of superior orbital fissure and orbital apex regions: critical considerations for clinical applications. Eur Arch Otorhinolaryngol 270(5):1643–1649CrossRefPubMed
9.
go back to reference Roth J, Fraser JF, Singh A et al (2011) Surgical approached to the orbital apex: comparison of endoscopic endonasal and transcranial approaches using a novel 3D Endoscope. Orbit 30(1):43–48CrossRefPubMed Roth J, Fraser JF, Singh A et al (2011) Surgical approached to the orbital apex: comparison of endoscopic endonasal and transcranial approaches using a novel 3D Endoscope. Orbit 30(1):43–48CrossRefPubMed
10.
go back to reference Castelnuovo P, Dallan I, Locatelli D et al (2012) Endoscopic endonasal intraorbital surgery: our experience with 16 cases. Eur Arch Otorhinolaryngol 269(8):1929–1935CrossRefPubMed Castelnuovo P, Dallan I, Locatelli D et al (2012) Endoscopic endonasal intraorbital surgery: our experience with 16 cases. Eur Arch Otorhinolaryngol 269(8):1929–1935CrossRefPubMed
11.
go back to reference McKinney KA, Snyderman CH, Carrau RL et al (2010) Seeing the light: endoscopic endonasal intraconal orbital tumor surgery. Otolaryngol Head Neck Surg 143(5):699–701PubMedCentralCrossRefPubMed McKinney KA, Snyderman CH, Carrau RL et al (2010) Seeing the light: endoscopic endonasal intraconal orbital tumor surgery. Otolaryngol Head Neck Surg 143(5):699–701PubMedCentralCrossRefPubMed
12.
go back to reference Tomazic PV, Stammberger H, Habermann W et al (2011) Intraoperative medialization of medial rectus muscle as a new endoscopic technique for approaching intraconal lesions. Am J Rhinol Allergy 25(5):363–367CrossRefPubMed Tomazic PV, Stammberger H, Habermann W et al (2011) Intraoperative medialization of medial rectus muscle as a new endoscopic technique for approaching intraconal lesions. Am J Rhinol Allergy 25(5):363–367CrossRefPubMed
13.
go back to reference Moe KS, Bergeron CM, Ellenbogen RG (2010) Transorbital neuroendoscopic surgery. Neurosurgery 67(3 Suppl Operative): ons16–28 Moe KS, Bergeron CM, Ellenbogen RG (2010) Transorbital neuroendoscopic surgery. Neurosurgery 67(3 Suppl Operative): ons16–28
14.
go back to reference Rivkin MA, Turtz AR, Morgenstern KE (2013) Transorbital endoscopic removal of posterior lateral orbital mass. Laryngoscope 123(12):3001–3004CrossRefPubMed Rivkin MA, Turtz AR, Morgenstern KE (2013) Transorbital endoscopic removal of posterior lateral orbital mass. Laryngoscope 123(12):3001–3004CrossRefPubMed
15.
go back to reference Sellari-Franceschini S (2012) Balanced orbital decompression in Graves’ orbitopathy. Oper Tech Otolaryngol Head Neck Surg 23(3):219–226CrossRef Sellari-Franceschini S (2012) Balanced orbital decompression in Graves’ orbitopathy. Oper Tech Otolaryngol Head Neck Surg 23(3):219–226CrossRef
16.
go back to reference Sonig A, Nanda A (2013) Transorbital approach to the anterior cranial skull base. World Neurosurg 80(6):810–812CrossRefPubMed Sonig A, Nanda A (2013) Transorbital approach to the anterior cranial skull base. World Neurosurg 80(6):810–812CrossRefPubMed
Metadata
Title
Transorbital endoscopic assisted resection of a superior orbital fissure cavernous haemangioma: a technical case report
Authors
Iacopo Dallan
Davide Locatelli
Mario Turri-Zanoni
Paolo Battaglia
Davide Lepera
Nicola Galante
Stefano Sellari-Franceschini
Paolo Castelnuovo
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 12/2015
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-015-3556-2

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