Decompression of Benign Orbital Apex Lesion Via Medial Endoscopic Approach

• DOI: 10.3109/01676830.2012.678920
• Publication Date: 2012-05-22T17:52:16Z
• Authors: David I. T. Sia; Weng Onn Chan; Peter J. Wormald; Garry Davis; Dinesh Selva
• Keywords: Adult; Surgical decompression; Visual Acuity; 610; Orbital diseases; Endoscopic surgical procedure; Endoscopy; Fibrous Dysplasia of Bone; Middle Aged; Decompression, Surgical; Diagnosis, Differential; 03 medical and health sciences; 0302 clinical medicine; Benign neoplasms; 616; Optic Nerve Diseases; Optic nerve diseases; Orbital Diseases; Humans; Female; Meningioma; Tomography, X-Ray Computed

The use of endoscopic orbital and optic nerve decompression for traumatic optic neuropathy and dysthyroid orbitopathy have been well documented; however, reports on endoscopic decompression for benign orbital apex lesions are scarce. The records of two patients who underwent endoscopic decompression of the bony orbit for progressive visual loss were reviewed. Patient 1 had fibrous dysplasia and presented with headache and visual field defects. Patient 2 had sphenoid wing meningioma and multiple previous attempts of transcranial tumor resection and orbital decompression. Both had progressive visual deterioration and ultimately underwent transnasal endoscopic orbital decompression. Post-operatively, both patients had subjective and objective improvement in visual function and compressive symptoms. No complications from the endoscopic decompression were observed in both patients. Transnasal endoscopic approach may be a viable option for decompression of benign orbital apex lesions.