Endoscopic transnasal drainage for orbital implantation cyst after orbital wall reconstruction

An implantation cyst after orbital wall reconstruction may present as a late complication, which can cause local pain, proptosis, diplopia, and vision impairment. Previous surgical strategies prefer transconjunctival or subtarsal approach for cyst drainage, a similar approach to orbital wall reconstruction. These strategies may have risk of secondary infection. Herein, we propose an endoscopic transnasal surgical approach, through which the removal of implant and cyst drainage can be performed conveniently. The residual, medial single-layer cyst wall is generally strong enough to support the orbital soft tissues without the need for a new implant. We believe this surgical approach can simplify the procedure, reduce the complications, and prevent cyst recurrence.