Background: The purpose of this review was to evaluate outcomes in transnasal endoscopic approaches for the management of extraconal and intraconal orbital tumors.
Methods: A systematic review of studies on purely endoscopic endonasal orbital tumor resections was conducted using the MEDLINE database. Data extracted and analyzed from selected studies included study type, sample size, demographics, symptomatology, tumor characteristics, complications, follow-up time, and recurrence.
Results: Thirty-nine studies were identified and included, containing patient data for 71 cases. Mean patient age was 47 years (range, 1-75 years), and 53.5% of patients were male. Primary site of the tumor was orbital in 69.0% of the cases, of which 51.0% were intraconal and 30.6% were extraconal. The most common reported histopathology was cavernous hemangioma (45.1%). Intraoperative complications were reported in 5.6% of cases. Postoperative complications were noted in 29.6% of cases, the majority of which were transient (76.2%). There was no significant difference in postoperative complication rate between intraconal and extraconal primary site tumors (p = 0.302). Recurrence rate was 4.2%.
Conclusion: Purely endoscopic endonasal resection of orbital tumors is a viable alternative technique to traditional external procedures, with the inherent advantages of minimally invasive surgery. This study of 71 cases represents the largest pooled sample size to date, and the increasing use of endoscopic procedures will allow for future analyses with greater statistical power.
Keywords: PRISMA; endoscopy; malignancy; neoplasm; orbital tumors; systematic review.
© 2014 ARS-AAOA, LLC.