Management of Orbital Masses: Outcomes of Endoscopic and Combined Approaches With No Orbital Reconstruction.
Publication/Presentation Date
1-1-2020
Abstract
INTRODUCTION: The endoscopic endonasal approach to management of orbital pathology has expanded. Due to the rarity of these conditions, most reports in the literature consist of small case reports. We report a series from a single institution with a focus on outcomes.
METHODS: A retrospective chart review was carried out between 2010 and 2018.
RESULTS: Twenty-four patients were identified (average age 58 years, 15 males, 9 females). Average follow-up was 14.9 months. Most common etiologies included cavernous hemangioma (7), metastases (6), idiopathic orbital inflammatory syndrome (6), orbital hematoma/clot (2), and schwannoma (1). Most common presenting symptoms were decreased visual acuity (8), proptosis (8), diplopia (7), and incidental findings (2). All patients underwent endoscopic medial wall orbital decompressions. Sixteen involved a combined open approach by an ophthalmologist. Pathology was either biopsied (15), resected (6), or could not be identified (3). No intraoperative complications were noted. No patients underwent orbital reconstruction of the medial wall. Six patients developed postoperative sinusitis successfully managed with antibiotics. One patient developed epistaxis managed conservatively. In 5 patients, Sino-Nasal Outcome Test-22 scores increased immediately postop and then decreased, whereas scores only decreased in 6 patients. Six patients noted reduced proptosis. There were no new cases of diplopia or worsening visual acuity.
CONCLUSIONS: A combined endoscopic endonasal and external approach can be useful for managing orbital lesions. Patients tolerated the procedure well with improvement in ocular symptoms and minimal sinonasal complications. Reconstruction of the medial wall may not be warranted to prevent postoperative diplopia.
Volume
11
First Page
2152656719899922
Last Page
2152656719899922
ISSN
2152-6575
Published In/Presented At
Rimmer, R. A., Graf, A. E., Fastenberg, J. H., Bilyk, J., Nyquist, G. G., Rosen, M. R., Rabinowitz, M. P., & Rabinowitz, M. R. (2020). Management of Orbital Masses: Outcomes of Endoscopic and Combined Approaches With No Orbital Reconstruction. Allergy & rhinology (Providence, R.I.), 11, 2152656719899922. https://doi.org/10.1177/2152656719899922
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
31984165
Department(s)
Administration and Leadership
Document Type
Article