Endoscopic-assisted transorbital extended orbital exenteration: A multi-institutional preclinical study

Area of Science:

• Otolaryngology
• Neurosurgery
• Ophthalmology

Background:

• Sinonasal malignancies with orbital invasion present a poor prognosis, even after orbital exenteration (OE).
• Extended-OE (EOE) has shown promising results for these challenging cases.
• The feasibility of an endoscopic approach to EOE was investigated.

Purpose of the Study:

• To evaluate the feasibility and safety of performing an extended orbital exenteration (EOE) using an endoscopic technique through the exenterated orbit (endoscopic-EOE).
• To assess the perceived difficulty and risks associated with each step of the endoscopic-EOE procedure.

Main Methods:

• The study involved 48 orbital dissections across three institutions.
• A questionnaire was designed to assess the feasibility and safety of each surgical step, with scores ranging from 1 (impossible/high risk) to 10 (easy/low risk).
• The questionnaire was completed by 25 anterior skull base surgeons from six countries.

Main Results:

• The step-by-step technique for endoscopic-EOE was thoroughly described.
• Surgeons rated the feasibility and safety of the procedure, with detailed statistical analysis of the scores.
• Mean, median, range, and interquartile range for feasibility and safety scores were reported.

Conclusions:

• Endoscopic-extended orbital exenteration (endoscopic-EOE) is a technically demanding but achievable surgical procedure.
• The study suggests that endoscopic-EOE is a feasible option for managing sinonasal malignancies with orbital invasion.
• Clinical validation is necessary to determine the actual outcomes and efficacy of endoscopic-EOE in patient care.