Applying of endoscopic endonasal access in the removal of orbital tumors.+

Patient O., born in 1965, was admitted to the State Institution “О.S. Kolomiychenko Otolaryngology Institute of National Academy of Medical Sciences of Ukraine” with complaints of diplopia in the eyes, discomfort in the left eye. According to the anamnesis, he has been suffered for several years. On objective examination, there was limited mobility of the eyeball inward and downward. The patient's visual acuity was not impaired.

Computed tomography revealed a clearly delineated, regular-shaped, lobular hyperintensive tumor in the medial part of the left orbit. Magnetic resonance imaging (MRI) revealed a hypointensive tumor on T1 and a hyperintensive tumor on T2 within the extraocular muscle cone, gently displacing the optic nerve.

The patient underwent removal of the tumor by combined access: endoscopic endonasal and transconjunctival.

Due to the large size of the tumor and its proximity to the optic nerve, safe removal of the tumor through transconjunctival access was impossible, but due to this the optic nerve is displaced laterally.

Endonasally with the help of an endoscope 0 °, 45 ° the lamina papiracea was exposed and carefully removed. Periorbitis was dissected with a sickle knife. Periorbital adipose tissue between the lower and medial rectus muscles was separated. The tumor was visualized and was carefully removed from the orbit without injuring the optic nerve.

In the postoperative period, visual acuity is preserved, diplopia was observed. According to histopathological examination - cavernous hemangioma. The result of computed tomography in the postoperative period - data for recurrence or residual effects were not found.

Conclusion:. The location of the tumor and the histological structure of the tumor, determines the type of approachchosen.

Publication History

Article published online:
24 May 2022