Removal of a Cavernous Hemangioma in the Orbital Apex via the Endoscopic Transnasal Approach: A Case Report

Abstract

Introduction: The aim of this study is to describe the case of a cavernous hemangioma extending from the orbital apex to the pterygopalatine fossa that was completely removed via an endoscopic transnasal approach.

Case Report: We report the case of a 48-year-old man who presented with right hemianopsia of the left eye. MRI revealed a 1.5×1.1 cm mass lesion extending from the infero-medial part of the left orbital apex to the pterygopalatine fossa. Removal of the lesion was performed via the endoscopic transnasal approach. Using this approach, a wide operative view of the entire extent of the lesion from the optic canal to the orbital apex and the pterygopalatine fossa was obtained, and complete removal of the lesion was performed safely. The pathological diagnosis was cavernous hemangioma.

Conclusion: The endoscopic transnasal approach is a safe, effective, and less invasive therapeutic modality for the removal of lesions extending from the infero-medial part of the left orbital apex to the pterygopalatine fossa. With appropriate patient selection, this approach improves access and visualization, and it enables performance of operative procedures with much less risk than the conventional microscopic transcranial or transfacial approaches.

Key words

orbital apex - pterygopalatine fossa - endoscopic transnasal approach - minimally invasive surgery - skull base

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