1. Endonasal resection of orbital cavernous venous malformations with septal preservation
- Author
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Wilson P Lao, Hector A. Perez, Kenneth De Los Reyes, Kristelle J. Lagabon, and Steve C. Lee
- Subjects
Adult ,Male ,Natural Orifice Endoscopic Surgery ,Nasal cavity ,medicine.medical_specialty ,Vascular Malformations ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Orbital mass ,medicine ,Humans ,030223 otorhinolaryngology ,Nasal Septum ,Surgical approach ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Magnetic Resonance Imaging ,Otorhinolaryngologic Surgical Procedures ,Surgery ,Treatment Outcome ,Surgical Manipulation ,medicine.anatomical_structure ,Otorhinolaryngology ,Small incision ,030220 oncology & carcinogenesis ,Cavernous Sinus ,business ,Orbit ,Organ Sparing Treatments - Abstract
Purpose Multiple surgical approaches have been described to maximize visualization and accessibility for resection while minimizing morbidity in the patient with orbital intraconal tumors. Transnasal endoscopic approaches have become increasingly standard in select orbital cavernous venous malformations but often require a partial septectomy. The purpose of this manuscript is to communicate a septal preserving modified transseptal approach. Methods A 37-year old male was found to have an inferomedial intraconal orbital mass, measuring up to 2.6 cm on magnetic resonance imaging. Binarial transseptal access with septal preservation was obtained with a Killian incision on the right and a small incision in the midseptum on the left. Results Successful tumor delivery through the nasal cavity resulted in orbital relaxation. Postoperative evaluation of the septum demonstrated an intact septum with nearly no evidence of septal trauma from surgical manipulation. Conclusion This technique is easily performed and affords adequate visualization and freedom of movement as traditional binarial transseptal approaches without the disadvantages of partial septal loss such as increased crusting, olfactory disturbance, and loss of nasoseptal flaps.
- Published
- 2021
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