Mordern approaces for orbital apex tumors removal

    Abstract

    Mordern approaces for orbital apex tumors removal

    Gorbachev D.S., Voronov A.V., Gaivoronsky A.I., Kulikov A.N, Haritonova N.N., Leongardt T.A, Gavrilov G.V., Kolbin A.A.

    Military medical academy by s.m. Kyrov, the department of ophthalmology, Saint-Petersburg

    Purpose. To present modern surgical tactics of removal of tumors of the orbital apex.

    Material and methods. 6 patients with tumors of the posterior part of the orbit were observed. Tumors were removed by three different approaches. Two patients underwent traditional transcutaneous orbital access. Two patients underwent transnasal endoscopic access with the participation of an ophthalmologist and an otorhinolaryngologist. In one patient, a combination of transconjunctival orbital and transnasal endoscopic approaches involving an ophthalmologist and an otorhinolaryngologist was used. One patient underwent tumor removal by subfrontal extradural access with the participation of a neurosurgeon and an ophthalmologist.

    Results. Complete removal of the tumor was performed in all 6 cases. In 5 cases, the operation went without complications. In one case, intraoperative difficulties were observed, which increased the duration of intervention due to the strong fixation of the tumor to the walls of the orbit, as well as trophic corneal disorders postoperatively.

    Conclusions. The choice of surgical access for the removal of the orbital apex tumors is advisible taking into account the localization of the tumor with the involvement of a multidisciplinary surgical team if necessary. That allows to remove hard-to-reach tumors in full with minimal tissue trauma.

    Key words: tumor of the orbital apex, transnasal endoscopic approach, subfrontal access.