title: Endoscopic approach to orbital apex lesions.
abstract: OBJECTIVE
  To examine the role of transnasal and transantral endoscopic surgical approaches in the management of apical orbital lesions.
  
  
  METHODS
  Retrospective case series.
  
  
  RESULTS
  Three patients underwent combined orbital and endoscopic surgery for treatment of apical orbital lesions. In two of these patients, the orbital apex was decompressed, which resulted in visual recovery. Using endoscopic approaches to the posterior orbit and orbital apex allowed better visualization, with minimal manipulation of tissues in an area where surgical access is limited.
  
  
  CONCLUSIONS
  Apical orbital lesion management benefits from a multidisciplinary and individualized plan. Endoscopic approaches can be used to improve visualization and access to a difficult surgical area. They also allow extra instrumentation to be used through the relatively capacious paranasal sinuses. These advantages may obviate lateral orbitotomy in some situations. Although endoscopic techniques are useful for biopsy, debulking, and removal of orbital apex lesions, they may be more difficult to apply to an intraconal lesion at the orbital apex.
authors.affiliation: Department of Ophthalmology, New York Presbyterian Hospital/Columbia-Presbyterian Center, New York, New York, USA.
authors.forename: Angelo
authors.initials: A
authors.lastname: Tsirbas
authors.forename: Michael
authors.initials: M
authors.lastname: Kazim
authors.forename: Lanny
authors.initials: L
authors.lastname: Close
mesh_terms: D001706:Biopsy; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006392:Hemangioma, Cavernous / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D018208:Liposarcoma, Myxoid / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009918:Orbital Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019291:Skull Base / Q000601:surgery; D014057:Tomography, X-Ray Computed