• Beste Gulsuna, Gökberk Erol, Ozan Yavuz Tüfek, Huy Quang Truong, Yiğit Aksoğan, Ali Nehir, Muammer Melih Sahin, and Emrah Celtikci.
• Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
• World Neurosurg. 2024 Jun 1; 186: e273e282e273-e282.

BackgroundLesions situated within the orbit pose significant challenges in management due to the confined space they occupy and their proximity to critical anatomical structures. The objective of our study is to assess the feasibility of the ipsilateral endoscopic endonasal approach for orbital cavernous hemangiomas and to comprehend the surgical anatomy of the orbital apex and inferomedial orbital structures.MethodsThirteen patients (8 women, 5 men), with ages ranging from 25 to 54 years (mean 35.2 ± 8.3 years), with orbital cavernous hemangioma who underwent surgery via the ipsilateral mononostril endoscopic endonasal approach between August 2018 and August 2023 were retrospectively evaluated. Demographic characteristics, clinical data, radiographic images, and clinical outcomes of the patients were collected from digital medical records.ResultsThe left orbit was more commonly affected (9 left, 4 right). The average postoperative follow-up duration was 22.2 months (range: 6-50 months). Among the 13 cases of orbital cavernous hemangioma, 1 (7.7%) was located in the extraconal compartment, and 12 (92.3%) were situated in the intraconal compartment. Complete surgical resection of the tumor was successfully achieved in all patients.ConclusionsOur study highlights the potential advantages of employing a purely ipsilateral mononostril endoscopic endonasal approach for orbital surgery, particularly for accessing the orbital apex and managing medial and inferomedial orbital lesions. This technique holds promise for reducing morbidity and enhancing outcomes, especially when combined with careful patient selection, preoperative planning, and advanced endoscopic skills.Copyright © 2024 Elsevier Inc. All rights reserved.

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