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
