Transorbital Endoscopic Approach for Managing Challenging Frontal Sinus Lesions: Results and Operative Technique...

Area of Science:

• Neurosurgery
• Endoscopic Sinus Surgery
• Skull Base Surgery

Background:

• Frontal sinus lesions present unique surgical challenges.
• Endoscopic transnasal approach (ETA) is a standard treatment, but some lesions require alternative access.
• Transorbital endoscopic approach (TEA) offers a complementary minimally invasive option.

Purpose of the Study:

• To describe the experience and step-by-step technique of using the transorbital endoscopic approach (TEA) for frontal sinus lesions.
• To evaluate the safety and efficacy of TEA in managing various frontal sinus pathologies.

Main Methods:

• Retrospective review of adult patients undergoing TEA for frontal sinus lesions between 2017 and 2022.
• TEA was performed in combination with ETA for lesion management.
• Data collected included patient demographics, lesion etiology, surgical outcomes, complications, and follow-up.

Main Results:

• Eight surgeries were performed on seven adult patients (average age 53.9 years) for frontal sinus lesions.
• Gross total resection (GTR) was achieved in all cases.
• Common indications included headaches (62.5%) and mucoceles (62.5%). Mild V1 numbness was the most frequent complication (62.5%), fully resolving within 6 months. Hospital stay averaged 1 day.

Conclusions:

• Transorbital endoscopic approach (TEA) is a valuable adjunct to ETA for frontal sinus lesions, particularly in difficult-to-access areas.
• TEA is a feasible and safe technique for achieving GTR in diverse frontal sinus pathologies.
• The approach effectively manages symptoms and results in short hospitalizations.