Endoscopic endonasal approach for ocular choristoma ofthe orbital apex and middle cranial fossa: Case report
Main Article Content
Abstract
Introduction: Endoscopic endonasal approaches are a tool for complex orbit and skull base lesions, offering better visualization and lower morbidity than open techniques. Clinical case: A 14-year-old female with left orbital apex compressive syndrome. Imaging suggestive of schwannoma. Complete resection was performed via an extended endoscopic endonasal transpterygoid approach. Definitive histopathological study revealed a cystic respiratory choristoma. Discussion: Orbital choristomas are extremely rare. For lesions in the orbital apex with extension to the middle fossa, the endonasal approach offers advantages: excellent visualization, no external incisions, and less neural manipulation. This is the second reported case managed with this technique. Conclusions: Orbital apex choristoma is a rare entity. The endoscopic endonasal approach is an effective and safe surgical option in selected cases, requiring an expert multidisciplinary team to optimize results.
Article Details
Section

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Este artículo es publicado por la Revista Acta de Otorrinolaringología & Cirugía de Cabeza y Cuello.
Este es un artículo de acceso abierto, distribuido bajo los términos de la LicenciaCreativeCommons Atribución-CompartirIgual 4.0 Internacional.( http://creativecommons.org/licenses/by-sa/4.0/), que permite el uso no comercial, distribución y reproducción en cualquier medio, siempre que la obra original sea debidamente citada.
eISSN: 2539-0856
ISSN: 0120-8411
How to Cite
References
1. Laezza MP, Alqahtani R, Lanni V, Iuliano A, Althaqib RN, Maktabi A, et al. Primary orbital respiratory epithelial cyst: A systematic review and two case reports. Ophthalmic Plast Reconstr Surg. 2024;40(4):e133–8. http://dx.doi.org/10.1097/ IOP.0000000000002647
2. Prevedello DM, Kassam AB, Gardner P, Zanation A, Snyderman CH, Carrau RL. “Q-tip” retractor in endoscopic cranial base surgery. Neurosurgery. 2010;66(2):363-6; discussion 366-7. http://dx.doi.org/10.1227/01.NEU.0000363703.05995.B8
3. Turanzas NJ, von Holstein SL, Wiencke AK, Toft PB, Heegaard S, Kessel L. Epidemiology and clinical characteristics of congenital choristomas in the ocular adnexa of pediatric patients. Arbeitsphysiologie. 2022;260(9):3069-74. http:// dx.doi.org/10.1007/s00417-022-05652-3
4. Tay E, Yee AC, Luthert PJ, Rose GE. Congenital respiratory epithelial cysts of the orbit: a rare cause of major orbital impairment. Ophthalmic Plast Reconstr Surg. 2014;30(5):e116- 9. http://dx.doi.org/10.1097/IOP.0b013e3182a64f6b
5. Pahwa S, Sharma S, Das CJ, Dhamija E, Agrawal S. Intraorbital cystic lesions: An imaging spectrum. Curr Probl Diagn Radiol. 2015;44(5):437-48. http://dx.doi.org/10.1067/j. cpradiol.2015.03.003
6. Khan M, Schulte J, Zinreich SJ, Aygun N. Overview of Diagnostic Imaging of the Head and Neck. En: Flint PW, Haughey BH, Lund VJ (editores). Cummings otolaryngology E-book: Head and neck surgery. 3-volume set. Elsevier; 2020. p. 90-140.
7. Gishti O, de Keizer ROB, Detiger SE, van Rij C, Slagter C, Paridaens D. Radiation optic neuropathy and retinopathy in patients with presumed benign intraorbital tumours treated with fractionated stereotactic radiotherapy. Eye (Lond). 2023;37(12):2470-4. http://dx.doi.org/10.1038/s41433-022- 02356-0
8. Constanzo F, Pinto J, Schmidt T. How I do it: endoscopic endonasal approach to the orbital apex. Acta Neurochir (Wien). 2021;163(12):3433-7. http://dx.doi.org/10.1007/s00701-021- 04900-5
9. Gulsuna B, Erol G, Tufek OY, Truong HQ, Aksogan Y, Nehir A, et al. Endoscopic endonasal approach to the orbit: A case series and clinical experience emphasizing the advantages of the ipsilateral mononostril technique. World Neurosurg. 2024;186:e273-82. http://dx.doi.org/10.1016/j. wneu.2024.03.122
10. Iturriaga Casanova E, Rodriguez JC, Truong HQ. Meckel’s Cave: Anterior Endoscopic Approaches and Surgical Anatomy. En: Stamm AC (editor). Transnasal endoscopic skull base and brain surgery: Surgical anatomy and its applications. 2.a ed. Nueva York: Thieme Medical; 2019. p. 467-73.