Endonasal Endoscopic Approach for Minimally Invasive Orbital Decompression in Nonthyroid Proptosis-A Scoping Review

Area of Science:

• Neurosurgery
• Ophthalmology
• Otorhinolaryngology

Background:

• The endoscopic endonasal approach (EEA) was initially developed for thyroid orbitopathy.
• EEA has since been adapted for treating proptosis from various non-thyroid causes.
• Systematic review of outcomes and complications for EEA in non-thyroid proptosis is needed.

Purpose of the Study:

• To systematically review surgical outcomes and complication rates.
• Focus on patients without thyroid proptosis undergoing endoscopic endonasal orbital decompression.

Main Methods:

• Searched databases for "orbital disease," "surgical decompression," and "endoscopic endonasal approach."
• Two independent reviewers screened titles and abstracts, followed by full-text review.
• Risk of bias assessed using ROBINS-I.

Main Results:

• Included 8 studies with 74 patients with non-thyroid proptosis.
• Successful proptosis reduction in 97.2% of patients.
• Low complication rates: transient diplopia (6.8%), transient facial dysesthesia (2.7%), ptosis (1.4%), infarction (1.4%), sinus obstruction (1.4%), enophthalmos (1.4%).

Conclusions:

• Medial orbital decompression via EEA is a feasible option for non-thyroid proptosis.
• EEA shows comparable primary outcomes to transorbital approaches.
• EEA appears to have a superior safety profile regarding complication rates.