Orbital tumours are notoriously difficult to operate on because they necessitate a multidisciplinary team approach to achieve the best results. The authors looked at the potential of using both ETOA and EEA to gain 360° circumferential access to orbital malignancies. Between April 2014 and June 2019, 16 patients with orbital malignancies received either ETOA or EEA. Eight patients (50%) had intraconal cancers, while another eight (50%) had extraconal tumours. The clinical outcomes and surgical techniques, including how the tumour was removed from the patient’s body, were examined. There were no evidence of malignancy in any of the patients who had ETO or ETA, according to the study. Clinical outcomes and surgical method details were examined. Orbital schwannoma, cavernous hemangioma, olfactory groove meningioma (n = 1), sphenoorbital meningioma, and metastatic osteosarcoma were among the orbital cancers (n 2). Immediately after surgery, 10 patients treated with ETOA had partial third nerve palsy (3 transient and 1 persistent) After surgery, eight (88.9%) of the nine patients with preoperative proptosis improved, whereas four (66.7%) of the six patients with visual complaints improved. In this series, there have been no postoperative CSF leaks or infections. Without requiring temporalis muscle dissection or orbitozygomatic osteotomy, ETOA or EEA based on a four-zone model with its epicentre around the optic nerve successfully gives minimally invasive 360° circumferential access to the entire orbit with acceptable morbidity.

Reference Link – https://thejns.org/view/journals/j-neurosurg/135/1/article-p103.xml