title: Transorbital endoscopic assisted resection of a superior orbital fissure cavernous haemangioma: a technical case report.
abstract: OBJECTIVE
  Superior orbital fissure and orbital apex lesions are challenging to manage, regardless of the approach chosen, due to the potential morbidity. The objectives of this study are to describe an innovative, minimally invasive surgical approach addressing this critical area and to discuss its indications and outcomes.
  
  
  METHODS
  A young patient presented with visual disturbances (reduction of color discrimination, central scotoma) and mild exophthalmos owing to the presence of a right orbital apex cavernous haemangioma with superior orbital fissure invasion.
  
  
  METHODS
  The lesion was removed via a minimally invasive, neuronavigated, transorbital superior eyelid endoscopic-assisted approach.
  
  
  METHODS
  Technical feasibility and safety, early and late complications, length of hospitalization time and follow-up data were collected and analyzed.
  
  
  RESULTS
  The lesion was radically resected minimizing the surgical morbidity and hospitalization time for the patient and with encouraging functional and cosmetic outcomes. No recurrences were observed 1 year after surgery.
  
  
  CONCLUSIONS
  The endoscopic-assisted transorbital approach should be considered a safe and effective option that can be applied in the treatment of lesions affecting such complex anatomical regions, as it offers excellent visualization of the surgical field, acceptable sequelae and reduced morbidity in relation to the traditional transcranial/transfacial approaches. Further studies and larger case series are needed in order to validate the reproducibility and range of applications of this surgical technique.
authors: First Otorhinolaryngologic Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors: Iacopo
authors: I
authors: Dallan
authors: Department of Neurosurgery, Civic Hospital, Legnano, Italy.
authors: Davide
authors: D
authors: Locatelli
authors: Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Via Guicciardini 9, Varese, Italy. tzmario@inwind.it.
authors: Mario
authors: M
authors: Turri-Zanoni
authors: Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Via Guicciardini 9, Varese, Italy.
authors: Paolo
authors: P
authors: Battaglia
authors: Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Via Guicciardini 9, Varese, Italy.
authors: Davide
authors: D
authors: Lepera
authors: Department of Neurosurgery, Civic Hospital, Legnano, Italy.
authors: Nicola
authors: N
authors: Galante
authors: First Otorhinolaryngologic Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors: Stefano
authors: S
authors: Sellari-Franceschini
authors: Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Via Guicciardini 9, Varese, Italy.
authors: Paolo
authors: P
authors: Castelnuovo
mesh_terms: D004724:Endoscopy / Q000379:methods*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006392:Hemangioma, Cavernous / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D038361:Neuronavigation; D009918:Orbital Neoplasms / Q000601:surgery*
keywords: Endoscopy; Orbital apex; Skull base; Superior eyelid approach; Superior orbital fissure