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Endoscopic endonasal resection of medial orbital lesions with intraoperative MRI

  • Clinical Article - Neurosurgical Techniques
  • Published:
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Abstract

Background

Various approaches have been described and used for operating on lesions in the orbit. The approach selection is based on the pathology in the orbit and its exact location. This study was performed to evaluate the endoscopic endonasal approach (EEA) for orbital lesions and application of intraoperative MRI (iMRI).

Methods

Since 2006, the present authors have performed 614 endoscopic endonasal procedures. iMRI was used in 409 of these cases. Three orbital lesions approached via the endonasal route with a minimum follow-up of 1 year were analysed.

Results

EEA was used in one case of intraconal cavernoma, one extraconal cavernoma and one solitary fibrous tumour in the orbit. The lesion was located medially to the optic nerve in all cases. Radical resection was achieved and the patient's vision was improved in two cases with a preoperative visual field deficit. iMRI was useful in two cases. In one case intraoperative MRI helped to find an intraconal lesion; in the other case iMRI led to evacuation of haemostatic material and blood, which was causing compression in the orbit.

Conclusions

The EEA should be considered whenever a lesion in the orbit is located medially to the optic nerve. Excellent results were achieved. iMRI proved useful in selected cases.

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Acknowledgement

We wish to thank Lenka Bernardová for technical support.

Conflicts of interest

None

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Authors and Affiliations

  1. Department of Neurosurgery, Charles University, 1st Medical Faculty, Central Military Hospital, U vojenske nemocnice 1200, 169 02, Prague, Czech Republic

    David Netuka, Václav Masopust & Vladimír Beneš

  2. Unit of Radiology, Central Military Hospital, Prague, Czech Republic

    Tomáš Belšán & Nora Profantová

Authors
  1. David Netuka
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  2. Václav Masopust
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  3. Tomáš Belšán
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  4. Nora Profantová
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  5. Vladimír Beneš
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Corresponding author

Correspondence to David Netuka.

Additional information

Supported by grant IGA MZ NT 13631.

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Netuka, D., Masopust, V., Belšán, T. et al. Endoscopic endonasal resection of medial orbital lesions with intraoperative MRI. Acta Neurochir 155, 455–461 (2013). https://doi.org/10.1007/s00701-012-1585-9

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  • DOI: https://doi.org/10.1007/s00701-012-1585-9

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