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360 Degrees Endoscopic Access to and Through the Orbit.

Davide Locatelli1,2,3, Pierlorenzo Veiceschi1, Alberto Daniele Arosio4

  • 1Division of Neurosurgery, Department of Biotechnology and Life Sciences, "Ospedale di Circolo e Fondazione Macchi", University of Insubria, Varese, Italy.

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PubMed
Summary

Minimally invasive endoscopic transorbital approaches (ETOA) offer safe and effective surgical access to orbital pathologies, reducing morbidity and improving cosmetic outcomes compared to traditional methods.

Keywords:
Endoscope-assistedEndoscopic endonasal approachInferior eyelidMultiportal approachesOptic nerveOrbitSkull base anatomySuperior eyelidSuperior orbital fissureTransorbital approachTranspalpebral

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Area of Science:

  • Neurosurgery
  • Ophthalmology
  • Minimally Invasive Surgery

Background:

  • Orbital pathologies present significant surgical challenges due to complex neurovascular structures.
  • Traditional transcranial and craniofacial approaches carry substantial morbidity.
  • Minimally invasive techniques have emerged to improve patient outcomes.

Purpose of the Study:

  • To comprehensively describe endoscopic-assisted techniques for 360° orbital access.
  • To evaluate indications, advantages, and limitations of endoscopic transorbital approaches (ETOA).
  • To compare ETOA with traditional microsurgical transcranial approaches.

Main Methods:

  • Review of endoscopic endonasal and transorbital approaches (including endonasal and transpalpebral).
  • Analysis of surgical corridors for intraorbital and cranial base lesions.
  • Comparative assessment of outcomes, including morbidity, cosmetic results, and complications.

Main Results:

  • Endoscopic transorbital approaches (ETOA) provide effective management for intraorbital and deep-seated cranial base lesions.
  • ETOA demonstrate favorable outcomes regarding morbidity, cosmetic results, and complication rates.
  • Endoscopic techniques facilitate comprehensive 360° access to the orbit and surrounding regions.

Conclusions:

  • Endoscopic transorbital approaches represent a significant advancement in managing orbital pathologies.
  • These minimally invasive techniques offer superior outcomes compared to traditional open surgeries.
  • ETOA provide versatile access to the orbit and adjacent cranial base structures.