Endoscopic transanal intraorbital surgery: preliminary considerations

Objectives: To present our experience on intraorbital lesions managed by means of an endonasal endoscopic approach. Methods: We collected data on 6 intraorbital medially-located lesions, all managed by means of an endonasal route. We retrospectively reviewed the technical details, complications, histology, and general outcome. Results: Endoscopic endonasal approach was effective in removing completely intraorbital extra-intraconal tumors in 3 cases, in performing biopsies for histological diagnosis in 2 intraorbital intraconal lesions, and in draining one extraconal abscess. No major complications were observed; in particular, there was no optic nerve damage. Minor temporary complications (diplopia) were seen only in 1 case. Enophthalmus was observed in one case. Conclusion: Our preliminary 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.