TRANSNASAL ENDOSCOPIC SURGERY - Dr. P. THULASI DAS
ORBITAL AND ORBITAL APEX TUMOURS
ENDOSCOPIC MEDIAL ORBITOTOMY WITH OR WITHOUT MEDIAL RECTUS RETRACTION FOR TUMORS
Transnasal Endoscopic approach is employed for removal of tumours and other lesions from the medial and infero medial orbit. The lamina papyracea is a paper thin bone, which can be deliberately opened to expose the orbital contents and extraconal lesions can be removed without much difficulty.
The medial rectus fills almost the entire medial orbit and prevents exposure of the intraconal structures and orbital apex. We have devised a technique of retracting this muscle downwards and posteriorly without compromising its function to obtain good exposure of the Orbital Apex. Well defined, capsulated lesions can be successfully and completely removed using this technique, with little morbidity. We have employed this technique in 30 cases and almost perfected it.
An endoscopic medial orbitotomy and medial retraction techniques were employed to expose the tumour and the same removed in toto