Endoscopic-Assisted Removal of Orbital Roof Lesions via a Skin Crease Approach

ABSTRACT

Objective: To describe the technique and indications for an endoscopic-assisted approach to orbital roof lesions. Materials and Methods: The technique was used for six cases of orbital roof lesions. An anterior orbitotomy was performed via an upper eyelid skin crease incision. Areas of the lesion behind the superior orbital rim or abutting the dura were removed with the aid of a rigid Storz 3-chip video-endoscope with 30-, 45-, or 70-degree tip. Results: Six patients with lesions involving the orbital roof were treated using endoscopic-assisted curettage. There were five males and one female with a mean age of 39.6 years (range, 5 months to 67 years). There were two cases each of cholesterol granuloma, Langerhans' cell histiocytosis, and orbital dermoid. The lesions were successfully removed in all cases with a good outcome. Average follow-up was 2.6 years; range, 6 months to 5 years. Conclusion: This technique may be suitable for selected erosive lesions of the superior orbit involving the orbital roof.

KEYWORDS

Orbital roof - endoscope - orbit

REFERENCES

• 1 Kasperbauer J L, Hinkley L. Endoscopic orbital decompression for Graves' ophthalmopathy.  Am J Rhinol. 2005;  19 603-606
• 2 Farwell D G, Strong E B. Endoscopic repair of orbital floor fractures.  Facial Plast Surg Clin North Am. 2006;  14 11-16
• 3 Tsirbas A, Kazim M, Close L. Endoscopic approach to orbital apex lesions.  Ophthal Plast Reconstr Surg. 2005;  21 271-275
• 4 Braunstein R E, Kazim M, Schubert H D. Endoscopy and biopsy of the orbit.  Ophthal Plast Reconstr Surg. 1995;  11 269-272
• 5 Rose G E. Endoscopic removal of periorbital lesions: where next?.  Orbit. 2002;  21 261-262
• 6 Malhotra R, Selva D, Wormald P J, Davis G. Video-endoscope assisted teaching during sub-periosteal orbital surgery.  Orbit. 2005;  24 113-116
• 7 Selva D, Chen C. Endoscopic approach to orbitofrontal cholesterol granuloma.  Orbit. 2004;  23 49-52
• 8 Perneczky A, Fries G. Endoscope-assisted brain surgery. Part 1: evolution, basic concept and current technique.  Neurosurgery. 1998;  42 219-224
• 9 Patrinely J R, Stal S, Weber R S. Periorbital and craniofacial surgery. In: Stewart WB Surgery of the Eyelid, Orbit, and Lacrimal System. Vol. 3. San Francisco; American Academy of Ophthalmology 1995
• 10 Kabil M S, Shahinian H K. Application of the supraorbital endoscopic approach to tumors of the anterior cranial base.  J Craniofac Surg. 2005;  16 1070-1074