Surgical results of patients with orbital lesions through minimally invasive approaches
Keywords:
neuroendoscopy, orbit, orbital diseases.Abstract
Introduction: Minimally invasive approaches to the orbit constitute novel methods for the surgical treatment of orbital lesions.
Objectives: To describe the surgical results of minimally invasive approaches in patients with orbital lesions.
Method: A descriptive retrospective study was carried out, which included 31 patients from the Hermanos Ameijeiras Hospital with a diagnosis of orbital lesions operated on using minimally invasive approaches with endoscopic support with their different variables: Approaches used, post-surgical results and complications. The degree of imaging resection, visual evaluation, disease status, and complications were determined postoperatively. For data analysis, absolute and relative frequencies were used as summary measures.
Results: A predominance of endoscopic endonasal approaches extended to the orbit was evident in 48.5 %. A 90.9 % total resection of the lesions was achieved. Among the complications: Diplopia 6.1 %, enophthalmos, ptosis, infection and hematoma, 3.0 % respectively.
Conclusions: Minimally invasive approaches to the orbit with endoscopic support are safe, effective procedures with a low complication rate.
Downloads
Download data is not yet available.
References
1. Loakeim-Ioannidou M, MacDonald SM. Evolution of Care of Orbital Tumors with Radiation Therapy. J Neurol Surg B Skull Base. 2020; 81(4):480-496. DOI: 10.1055/s-0040-1713894
2. Reith W, Yilmaz U. Orbita: Teil 1: Anatomie, bildgebende Verfahren und retrobulbäre Läsionen. Radiologe. 2015; 55(8):701-18. DOI: 10.1007/s00117-015-2868-y
3. Alkatan HM, Al Marek F, Elkhamary S. Demographics of Pediatric Orbital Lesions: A Tertiary Eye Center Experience in Saudi Arabia. J Epidemiol Glob Health. 2019; 9(1):3-10. DOI: 10.2991/jegh.k.181224.001
4. Alsalamah AK, Maktabi AM, Alkatan HM. Adult Orbital Lesions in Saudi Arabia: A Multi-centered Demographic Study with Clinicopathological Correlation. J Epidemiol Glob Health. 2020; 10(4):359-66. DOI: 10.2991/jegh.k.200720.001
5. Wang LY, Shao A, Meng SK, Huang FB, Bai HX, Gao T, et al. Zhonghua Yan Ke Za Zhi. 2023; 59(1):20-25. DOI: 10.3760/cma.j.cn112142-20220802-00373
6. Wang LY, Chen LR, Dai XZ, Cao J, Gao T, Yao K, et al. A clinicopathological classification analysis of ocular mass lesions in 7910 cases. Zhonghua Yan Ke Za Zhi. 2019; 55(11):847-53. DOI: 10.3760/cma.j.issn.0412-4081.2019.11.011
7. Jonas RA, Rokohl AC, Kakkassery V, Ponto KA, Lohneis P, Heindl LM. Diagnostik von benignen und malignen Tumoren der Orbita. Ophthalmologe. 2021; 118(10):987-94. DOI: 10.1007/s00347-021-01429-x
8. Poloschek CM, Lagrèze WA, Ridder GJ, Hader C. Klinische und neuroradiologische Diagnostik bei Orbitatumoren. Ophthalmologe. 2011; 108(6):510-8. DOI: 10.1007/s00347-010-2190-z
9. de Melo Junior JO, de Castro MFAR, Landeiro JA. Orbitozygomatic approach for large orbital cavernous hemangioma. Surg Neurol Int. 2021; 12:320. DOI: 10.25259/SNI_274_2021
10. Gockeln R, Winter R, Sistani F, Kretschmann U, Hussein S. Minimal invasive decompression of the orbit in Graves' orbitopathy. Strabismus. 2000; 8(4):251-9. DOI: 10.1076/stra.8.4.251.681
11. Mueller SK, Bleier BS. Endoscopic surgery for intraconal orbital tumors. HNO. 2022; 70(5):345-351. DOI: 10.1007/s00106-022-01156-y
12. Snyderman CH, Pant H, Carrau RL, Prevedello D, Gardner P, Kassam AB. What are the limits of endoscopic sinus surgery?. The expanded endonasal approach to the skull base. Keio J Med. 2009; 58(3):152-60. DOI: 10.2302/kjm.58.152
13. Dubal PM, Svider PF, Denis D, Folbe AJ, Eloy JA. Short-term outcomes of purely endoscopic endonasal resection of orbital tumors: a systematic review. Int Forum Allergy Rhinol. 2014; 4(12):1008-15. DOI: 10.1002/alr.21402
14. Arai Y, Kawahara N, Yokoyama T, Oridate N. Endoscopic transnasal approach for orbital tumors: A report of four cases. Auris Nasus Larynx. 2016; 43(3):353-8. DOI: 10.1016/j.anl.2015.10.009
15. Curragh DS, Halliday L, Selva D. Endonasal Approach to Orbital Pathology. Ophthalmic Plast Reconstr Surg. 2018; 34(5):422-7. DOI: 10.1097/IOP.0000000000001180
16. Montano N, Lauretti L, D'Alessandris QG, Rigante M, Pignotti F, Olivi A, et al. Orbital Tumors: Report of 70 Surgically Treated Cases. World Neurosurg. 2018; 119:e449-e458. DOI: 10.1016/j.wneu.2018.07.181
17. Ma J, Zhou B, Qian H, Huang Z, Jitong S. Transnasal Endoscopic Resection of Orbital Cavernous Hemangiomas: Our Experience With 23 Cases. Int Forum Allergy Rhinol. 2019;9(11):1374-80. DOI: 10.1002/alr.22383
18. Ketharanathan B, Andersen MS, Pedersen CB, Darling P, Jakobsen J, Molander LD, et al. Endonasal Endoscopic Approach for Minimally Invasive Orbital Decompression in Nonthyroid Proptosis-A Scoping Review. World Neurosurg. 2022; 162:85-90. DOI: 10.1016/j.wneu.2022.03.075
19. Shemesh R, Yakirevitch A, Abergel A, Leibovitch I, Ben Simon G, Ben CnaanR. Endoscopic approach for orbital apex lesions: Case series and review of the literature. The Journal of Laryngology and Otology. 2023;137(4): 419-25. DOI: 10.1017/S0022215122001323
20. Sindwani R, Sreenath SB, Recinos PF. Endoscopic Endonasal Approach to Intraconal Orbital Tumors: Outcomes and Lessons Learned. Laryngoscope. 2023. DOI: 10.1002/lary.30757
21. Rimmer RA, Graf AE, Fastenberg JH, Bilyk J, Nyquist GG, Rosen MR, et al. Management of Orbital Masses: Outcomes of Endoscopic and Combined Approaches With No Orbital Reconstruction. Allergy Rhinol (Providence). 2020; 11:2152656719899922. DOI: 10.1177/2152656719899922
22. Shin M, Kondo K, Hanakita S, Suzukawa K, Kin T, Shojima M, et al. Endoscopic transnasal approach for resection of locally aggressive tumors in the orbit. J Neurosurg. 2015; 123(3):748-59. DOI: https://doi.org/10.3171/2014.11.JNS141921
2. Reith W, Yilmaz U. Orbita: Teil 1: Anatomie, bildgebende Verfahren und retrobulbäre Läsionen. Radiologe. 2015; 55(8):701-18. DOI: 10.1007/s00117-015-2868-y
3. Alkatan HM, Al Marek F, Elkhamary S. Demographics of Pediatric Orbital Lesions: A Tertiary Eye Center Experience in Saudi Arabia. J Epidemiol Glob Health. 2019; 9(1):3-10. DOI: 10.2991/jegh.k.181224.001
4. Alsalamah AK, Maktabi AM, Alkatan HM. Adult Orbital Lesions in Saudi Arabia: A Multi-centered Demographic Study with Clinicopathological Correlation. J Epidemiol Glob Health. 2020; 10(4):359-66. DOI: 10.2991/jegh.k.200720.001
5. Wang LY, Shao A, Meng SK, Huang FB, Bai HX, Gao T, et al. Zhonghua Yan Ke Za Zhi. 2023; 59(1):20-25. DOI: 10.3760/cma.j.cn112142-20220802-00373
6. Wang LY, Chen LR, Dai XZ, Cao J, Gao T, Yao K, et al. A clinicopathological classification analysis of ocular mass lesions in 7910 cases. Zhonghua Yan Ke Za Zhi. 2019; 55(11):847-53. DOI: 10.3760/cma.j.issn.0412-4081.2019.11.011
7. Jonas RA, Rokohl AC, Kakkassery V, Ponto KA, Lohneis P, Heindl LM. Diagnostik von benignen und malignen Tumoren der Orbita. Ophthalmologe. 2021; 118(10):987-94. DOI: 10.1007/s00347-021-01429-x
8. Poloschek CM, Lagrèze WA, Ridder GJ, Hader C. Klinische und neuroradiologische Diagnostik bei Orbitatumoren. Ophthalmologe. 2011; 108(6):510-8. DOI: 10.1007/s00347-010-2190-z
9. de Melo Junior JO, de Castro MFAR, Landeiro JA. Orbitozygomatic approach for large orbital cavernous hemangioma. Surg Neurol Int. 2021; 12:320. DOI: 10.25259/SNI_274_2021
10. Gockeln R, Winter R, Sistani F, Kretschmann U, Hussein S. Minimal invasive decompression of the orbit in Graves' orbitopathy. Strabismus. 2000; 8(4):251-9. DOI: 10.1076/stra.8.4.251.681
11. Mueller SK, Bleier BS. Endoscopic surgery for intraconal orbital tumors. HNO. 2022; 70(5):345-351. DOI: 10.1007/s00106-022-01156-y
12. Snyderman CH, Pant H, Carrau RL, Prevedello D, Gardner P, Kassam AB. What are the limits of endoscopic sinus surgery?. The expanded endonasal approach to the skull base. Keio J Med. 2009; 58(3):152-60. DOI: 10.2302/kjm.58.152
13. Dubal PM, Svider PF, Denis D, Folbe AJ, Eloy JA. Short-term outcomes of purely endoscopic endonasal resection of orbital tumors: a systematic review. Int Forum Allergy Rhinol. 2014; 4(12):1008-15. DOI: 10.1002/alr.21402
14. Arai Y, Kawahara N, Yokoyama T, Oridate N. Endoscopic transnasal approach for orbital tumors: A report of four cases. Auris Nasus Larynx. 2016; 43(3):353-8. DOI: 10.1016/j.anl.2015.10.009
15. Curragh DS, Halliday L, Selva D. Endonasal Approach to Orbital Pathology. Ophthalmic Plast Reconstr Surg. 2018; 34(5):422-7. DOI: 10.1097/IOP.0000000000001180
16. Montano N, Lauretti L, D'Alessandris QG, Rigante M, Pignotti F, Olivi A, et al. Orbital Tumors: Report of 70 Surgically Treated Cases. World Neurosurg. 2018; 119:e449-e458. DOI: 10.1016/j.wneu.2018.07.181
17. Ma J, Zhou B, Qian H, Huang Z, Jitong S. Transnasal Endoscopic Resection of Orbital Cavernous Hemangiomas: Our Experience With 23 Cases. Int Forum Allergy Rhinol. 2019;9(11):1374-80. DOI: 10.1002/alr.22383
18. Ketharanathan B, Andersen MS, Pedersen CB, Darling P, Jakobsen J, Molander LD, et al. Endonasal Endoscopic Approach for Minimally Invasive Orbital Decompression in Nonthyroid Proptosis-A Scoping Review. World Neurosurg. 2022; 162:85-90. DOI: 10.1016/j.wneu.2022.03.075
19. Shemesh R, Yakirevitch A, Abergel A, Leibovitch I, Ben Simon G, Ben CnaanR. Endoscopic approach for orbital apex lesions: Case series and review of the literature. The Journal of Laryngology and Otology. 2023;137(4): 419-25. DOI: 10.1017/S0022215122001323
20. Sindwani R, Sreenath SB, Recinos PF. Endoscopic Endonasal Approach to Intraconal Orbital Tumors: Outcomes and Lessons Learned. Laryngoscope. 2023. DOI: 10.1002/lary.30757
21. Rimmer RA, Graf AE, Fastenberg JH, Bilyk J, Nyquist GG, Rosen MR, et al. Management of Orbital Masses: Outcomes of Endoscopic and Combined Approaches With No Orbital Reconstruction. Allergy Rhinol (Providence). 2020; 11:2152656719899922. DOI: 10.1177/2152656719899922
22. Shin M, Kondo K, Hanakita S, Suzukawa K, Kin T, Shojima M, et al. Endoscopic transnasal approach for resection of locally aggressive tumors in the orbit. J Neurosurg. 2015; 123(3):748-59. DOI: https://doi.org/10.3171/2014.11.JNS141921
Published
2024-01-17
How to Cite
1.
Ortiz Machín MM, López Arbolay O, Vargas Gálvez CR, Varela Baró AE. Surgical results of patients with orbital lesions through minimally invasive approaches. Rev Cubana Med Milit [Internet]. 2024 Jan. 17 [cited 2025 Apr. 7];53(1):e024022823. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/22823
Issue
Section
Brief Communication
License
Authors who have publications with this Journal accept the following terms:
- The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
- The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
- Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.
