Endoscopic Intraconal Orbit Surgery

Purpose of ReviewEndoscopic approaches to the orbit have significantly expanded from endoscopic orbital decompression and dacryocystorhinostomy to use in resection of orbital tumors. Within the compact space of the orbit, there are critical neurovascular structures and important considerations regarding the management and treatment of pathologies in this region. This review will outline the anatomy of the orbit from an endoscopic perspective and how it can be accessed for tumor extirpation through the nasal corridor using endoscopic sinus surgery. It will discuss the various advancements in approach and visualization, as well as considerations for tumor removal and reconstruction.Recent FindingsThe understanding and implementation of endoscopic approaches for orbital tumors has increased greatly in the last decade, as surgeons have refined their skills with endoscopic skull base surgery. Today, complex tumors that were previously approached externally can now be managed endoscopically. There have been several advances in anatomical knowledge and surgical technique, as well as indications for these approaches. Initial results have been favorable with the ability to resect intraconal tumors without complication, all while avoiding facial incisions and significant globe retraction.SummaryPathology within the intraconal space provides a unique challenge with regard to treatment due to its sensitive location. The endoscopic endonasal approach to orbital tumors is a viable option with comparable outcomes to open approaches when used in the properly selected patient.