Endonasal Approach to Orbital Pathology

Purpose: Transnasal endoscopic orbital surgery in an emerging surgical field. The surgical field has expanded from orbital decompression to excision of tumours from the medial orbit and over the last 20 years. As instrumentation has improved, the nature, location and size of tumours being excised has changed. Methods: This article discusses the salient surgical considerations when approaching an orbital lesion via a transnasal endoscopic route and reviews the literature. Results: An endonasal approach offers a potential space surgeons can utilise to access the orbit, possibly providing additional exposure, illumination and magnification to the medial and apical aspects of selected lesions. Conclusions: An endonasal approach may be useful as a sole or adjunctive approach in selected cases of orbital tumour excision.