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      Transorbital neuroendoscopic management of sinogenic complications involving the frontal sinus, orbit, and anterior cranial fossa.

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          Abstract

          Transnasal endoscopic surgery has remained at the forefront of surgical management of sinogenic complications involving the frontal sinus, orbit, and anterior skull base. However, the difficulty in accessing certain areas of these anatomical regions can potentially limit its use. Transorbital neuroendoscopic surgery (TONES) was recently introduced to transgress the limits of transnasal endoscopic surgery; the access that it provides could add additional surgical pathways for treating sinogenic complications involving the frontal sinus, orbit, and anterior cranial fossa. We describe a prospective series of 13 patients who underwent TONES for the management of various sinogenic complications, including epidural abscess, orbital abscess, and fronto-orbital mucocele or mucopyocele, as well as subperiosteal abscess presenting with orbital apex syndrome. The primary outcome measurement was the efficacy of TONES in treating these pathologies. TONES provided effective access to the frontal sinus, orbit, and the anterior cranial fossa. All patients demonstrated postoperative resolution of initial clinical symptoms with well-hidden surgical scars. There were no ophthalmologic complications or recurrence of pathology. Based on our experience, TONES appears to provide a valuable addition to the current surgical armamentarium for treating selected complications of sinusitis.

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          Author and article information

          Journal
          J Neurol Surg B Skull Base
          Journal of neurological surgery. Part B, Skull base
          Georg Thieme Verlag KG
          2193-6331
          2193-634X
          Dec 2012
          : 73
          : 6
          Affiliations
          [1 ] Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.
          Article
          73394
          10.1055/s-0032-1329617
          3578590
          24294556
          e54abdf3-0c83-418d-a406-eec35cea2558
          History

          transconjunctival,endoscopic,epidural abscess,frontal sinus abscess,mucocele,mucopyocele,multiportal,orbital abscess,sinusitis complications,skull base,transorbital,transpalpebral

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