Navigating the Orbit: Endoscopic Transnasal Transorbital Approach to Orbital Cavernous Hemangiomas

Orbital cavernous hemangiomas are common benign orbital tumors often presenting with slowly progressive proptosis, visual disturbances, or diplopia. Although histologically the lesion is benign in nature, its features, such as a progressive increase in tumor size, result in optic nerve compression necessitating surgical removal. Traditional external approaches such as lateral orbitotomy or transcranial surgery are the most commonly employed approaches, but they are associated with higher morbidity, significant tissue disruption and visible scarring. Evolution of Endoscopic Skull Base Surgical Techniques has helped surgeons in designing a cosmetically favourable minimally invasive route.

Here we report a case of a 69-year-old male diagnosed with a right orbital cavernous hemangioma who underwent endoscopic transnasal transorbital approach and excision of lesion under neuronavigation guidance.

This case report highlights the growing role of endoscopic transnasal approaches in the management of orbital lesions by providing direct access to medial and infero-medial orbital compartments.