title: Posterior nasal septectomy in endoscopic orbital apex surgery.
abstract: OBJECTIVE
  To review cases of endoscopic orbital apex surgery using posterior nasal septectomy and describe the technique and benefits.
  
  
  METHODS
  A retrospective chart review of all cases of endoscopic orbital apex surgery with the use of intraoperative posterior nasal septectomy over a 3-year period. Three cases are described, and the technique and limitations and advantages of this approach are detailed.
  
  
  RESULTS
  Endoscopic orbital apex surgery cases over a 3-year period were reviewed. Three of these cases involved the use of posterior nasal septectomy. All 3 cases involved large lesions at the orbital apex and periorbital skull base. Two of the lesions also involved the cavernous sinus and one extended in the optic canal. The alternative for all patients would have involved a transcranial approach. During the mean follow-up of 9 months, no complications were noted.
  
  
  CONCLUSIONS
  The use of posterior nasal septectomy in endoscopic surgery has been used for access of the skull base. This is the first description of this technique for access of orbital apical lesions. This technique improves visualization and surgical access to the orbital apex and periorbital skull base, sparing the patient larger craniofacial surgeries. No complications were noted in this preliminary patient cohort.
authors.affiliation: Oculoplastic and Orbital Surgery Service, Wills Eye Institute, Philadelphia, Pennsylvania 19107, USA. amurchison@willseye.org
authors.forename: Ann P
authors.initials: AP
authors.lastname: Murchison
authors.forename: Marc R
authors.initials: MR
authors.lastname: Rosen
authors.forename: James J
authors.initials: JJ
authors.lastname: Evans
authors.forename: Jurij R
authors.initials: JR
authors.lastname: Bilyk
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002813:Chondrosarcoma / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009300:Nasal Septum / Q000601:surgery*; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D009918:Orbital Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult