Endoscopic bimanual approach to an intraconal cavernous hemangioma of the orbital apex with vascularized flap reconstruction.
The aim of this study was to describe a transnasal endoscopic bimanual technique for the removal of an intraconal orbital apex cavernous hemangioma. Report of a surgical technique. A 39-year-old woman with unilateral visual loss and proptosis was found to have an intraconal orbital apex mass consistent radiographically with cavernous hemangioma. Because of its posteromedial location within the orbit, a transnasal 4-handed endoscopic technique was used with pedicled nasoseptal flap reconstruction. The tumor was excised, and the patient had no complications. The transnasal endoscopic approach to orbital apex cavernous hemangioma excision is a viable surgical approach for these difficult to access lesions. The medial orbital wall may be simultaneously reconstructed to prevent diplopia and enophthalmos.
Departments of *Otolaryngology and †Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
David Y
DY
Healy
N Grace
NG
Lee
Suzanne K
SK
Freitag
Benjamin S
BS
Bleier
D000328:Adult; D004724:Endoscopy; D005260:Female; D006392:Hemangioma, Cavernous / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009389:Neovascularization, Pathologic / Q000473:pathology*; D013508:Ophthalmologic Surgical Procedures; D009918:Orbital Neoplasms / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps / Q000098:blood supply*