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TRANSNASAL ENDOSCOPIC SURGERY - Dr. P. THULASI DAS

ENDOSCOPIC SURGERY FOR ORBITAL LESIONS

ORBITAL AND ORBITAL APEX TUMOURS

ENDOSCOPIC MEDIAL ORBITOTOMY WITH OR WITHOUT MEDIAL RECTUS RETRACTION FOR TUMORS

Transnasal Endoscopic approach is employed for removal of tumours and other lesions from the medial and infero medial orbit. The lamina papyracea is a paper thin bone, which can be deliberately opened to expose the orbital contents and extraconal lesions can be removed without much difficulty.

Click below image to enlarge view

Retraction of medial rectus with a fine rubber catheter to expose the orbital apex

The medial rectus fills almost the entire medial orbit and prevents exposure of the intraconal structures and orbital apex. We have devised a technique of retracting this muscle downwards and posteriorly without compromising its function to obtain good exposure of the Orbital Apex. Well defined, capsulated lesions can be successfully and completely removed using this technique, with little morbidity. We have employed this technique in 30 cases and almost perfected it.

Click below image to enlarge view

Globular tumour in the orbital apex
Orbital apex is noman`s land

An anterior approach is associated with morbidity and disturbs the orbital structures

Transnasal endoscopic approach was employed
and disturbs the orbital structures

An endoscopic medial orbitotomy and medial retraction techniques were employed to expose the tumour and the same removed in toto

 


 

 
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