Endoscopic Endonasal Management of Orbital Pathologies

Based on the anatomic relationship between sinonasal complex and orbit, endoscopic transnasal procedures could be a smart solution for approaching the medial orbital region. These techniques should be considered a valid option for optic nerve or orbital wall decompression in cases of Graves ophthalmopathy and post-traumatic optic neuropathy as well as for addressing extraconal or intraconal lesions placed medially to the optic nerve course. This article describes the anatomic principles, indications, technical nuances, and limitations of the endoscopic endonasal approaches for the management of selected orbital pathologic abnormalities.