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Updated: Jan 11, 2026

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Transorbital endoscopic approaches: Applications in orbital surgery.

Jessica Y Tong1, Jeffrey Sung2, WengOnn Chan1

  • 1South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia; Discipline of Ophthalmology and Vision Sciences, University of Adelaide, Adelaide, Australia; Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.

Survey of Ophthalmology
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PubMed
Summary

Transorbital endoscopic approaches (TEAs) offer a minimally invasive option for orbital surgery. These techniques provide favorable outcomes with a low risk of permanent sequelae for various orbital pathologies.

Keywords:
Cavernous venous malformationIntraconal orbital lesionOrbital and optic canal decompressionOrbital apexOrbital fracture repairSuperior eyelid creaseTransorbital endoscopic approach

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Area of Science:

  • Neurosurgery
  • Ophthalmology
  • Minimally Invasive Surgery

Background:

  • Transorbital endoscopic approaches (TEAs) have evolved significantly over the past two decades.
  • The nomenclature distinction between TEAs and transorbital neuroendoscopic surgery can be ambiguous.
  • This review focuses specifically on TEAs for primary orbital pathology.

Purpose of the Study:

  • To review the current literature on transorbital endoscopic approaches for primary orbital pathology.
  • To discuss the evolution, applications, and outcomes of TEAs.
  • To highlight the advantages and limitations of TEAs in orbital surgery.

Main Methods:

  • Review of preclinical cadaveric dissection studies.
  • Analysis of clinical case reports and case series.
  • Focus on literature detailing TEAs for primary orbital lesions.

Main Results:

  • Early TEAs primarily accessed orbital roof lesions via superior lid crease incisions.
  • TEAs have expanded to address lesions in extraconal and intraconal spaces, and the orbital apex.
  • Clinical series report favorable outcomes with a low risk of permanent functional sequelae.

Conclusions:

  • Transorbital endoscopic approaches are increasingly utilized for diverse orbital pathologies.
  • TEAs demonstrate a favorable safety profile with minimal risk of permanent functional deficits.
  • Further discussion on the advantages and limitations of TEAs is warranted.