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CC BY 4.0 · Surg J (N Y) 2018; 04(03): e105-e109
DOI: 10.1055/s-0038-1661417
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

“Push–Pull Technique” for the Management of a Selected Superomedial Intraorbital Lesion

Paolo Castelnuovo
1   Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria-Varese, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
4   Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRC), Department of Biotechnology and Life Sciences, University of Insubria-Varese, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
,
Giacomo Fiacchini
2   Otorhinolaryngology, Audiology and Phoniatrics Operative Unit, Department of Surgical, Medical, Molecular Pathology and Emergency Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
,
Francesca Romana Fiorini
3   First ENT Unit, Azienda Ospedaliero-Universitaria Pisana, Department of Surgical, Medical, Molecular Pathology and Emergency Medicine, University of Pisa, Pisa, Italy
,
Iacopo Dallan
2   Otorhinolaryngology, Audiology and Phoniatrics Operative Unit, Department of Surgical, Medical, Molecular Pathology and Emergency Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
4   Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRC), Department of Biotechnology and Life Sciences, University of Insubria-Varese, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
› Author Affiliations
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Publication History

22 February 2018

16 May 2018

Publication Date:
20 June 2018 (online)

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Abstract

Orbital lesions are traditionally managed through external approaches when laterally located, and through a transnasal approach or other external approaches when medially located. However, when the lesion is superomedially located, it may determine a technical challenge.

In this study, we present the case of a patient with a superomedial intraconal venous malformation of the left eye. We addressed the mass through a combined approach, using the transnasal route as the main approach, and the superior eyelid approach to push down the lesion to facilitate the excision. We have called this approach “push–pull technique.”

We achieved a complete resection of the lesion and did not observe any intraoperative or postoperative complications. The last follow-up at 6 months postoperatively showed no recurrence, and the patient was satisfied and completely recovered.

According to our experience, the “push–pull” technique seems to be a safe procedure and might be considered a valid alternative to address selected superomedial intraconal lesions.

Keywords

orbital lesion - orbital surgery - intraconal venous malformation - endoscopic transnasal approach - superior eyelid approach
 

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