Endoscopic Approach to Orbital Cavernous Haemangioma (OCH) and Intraconal Tumours: Surgical Anatomy and Techniques

Banks, Catherine; Bleier, Benjamin

Endoscopic Approach to Orbital Cavernous Haemangioma (OCH) and Intraconal Tumours: Surgical Anatomy and Techniques

Open Education Resource

2025-03-08

Abstract

The position of intraconal tumors relative to the optic nerve dictates the choice of surgical approach. Tumours with their epicenter medial to the optic nerve or “below a plane of resectability” (POR), which represents a plane subtended by the contralateral nostril and the long axis of the optic nerve, are amenable to an endoscopic approach. The feasibility and safety of this approach has been demonstrated in the literature. Tumours located lateral and superior to the POR are not candidates for an exclusively endoscopic resection. The composition of the surgical team var-ies depending on the institution. However, a multidisciplinary team including an oto-laryngologist, oculoplastic surgeon and in some cases, a neurosurgeon, is invaluable. The endoscopic approach to intraconal tumours will be described in this chapter using orbital cavernous haemangioma (OCH) as an example, as is it the most common primary orbital tumour in adults, with a reported incidence of 5-15% of all orbital tumours (Figure 1).