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13.
Endoskopski posegi v očnicah = Endoscopic surgery of the orbits
Podboj, Jernej ; Boršoš, Imre ; Kurent, Zoran
Introduction: The development of the endoscopic surgical technique and modern diagnostic methods, along with the introduction of powered instrumentation andcomputer-assisted surgery allow the ...widening of indications for the use of endoscopic surgery in the management of pathological processes of the orbit. Patients: At the Otorhinolaryngology and Cervicofacial Surgery Department in Ljubljana, 21 patients with pathological processes of the orbits have undergone endoscopic surgery since 1988. Twelve patients underwent endoscopic drainage of orbital abscesses resulting from sinusitis, and one endoscopic drainage of an orbital hematoma. Five patients with endocrine ophthalmopathy had bilateral orbital decompression, while one patient with neurofibromatosis had unilateral orbital decompression. One female patient underwent endoscopic removal of an orbital hemangioma, and a male had an endoscopic orbital biopsy that verified metastatic carcinoma. Results: There were no intraoperative or postoperative complications. After endoscopic drainage of the orbital abscesses and hematoma, the condition normalised within 24 hours. Following endoscopic orbital decompression, exophthalmos was reduced by an average of 2 mm. The patient who underwent endoscopic removal of an orbital hemangioma still has no symptoms 6 years after surgery. The patient with verified metastasis in the orbit received local radiotherapy. Discussion: The endoscopic surgical technique permits an accurate approach to pathological processes in the lower and medial orbital regions. Close cooperation between the ENT surgeon and the ophthalmologist and radiologist is important. Comparedto classical surgery, endoscopic operations are much less traumatic and stressful for the patient, the postoperative course is less unpleasant, the hospital stay is shorter, and the patient has no visible postoperative scars.
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