Endoscopic Endonasal Surgery of Orbital Tumors: What the Surgeon Wants to Know

Endoscopic endonasal surgery of the orbit is a novel, minimally invasive surgical technique that allows for biopsy, decompression, or resection of masses in the medial orbit and orbital apex. This review discusses the surgical procedure, preprocedure imaging technique, important surgical decision points and their implications for the radiologist, and the pearls and pitfalls encountered at our institution. A review of important medial intraorbital anatomy and relevant sinus anatomy will help the radiologist provide valuable information to the surgical team. In particular, understanding the course of the ophthalmic artery, the relationship of the lesion with the optic nerve, and the annulus of Zinn are important considerations.

Learning Objective: Review the endoscopic endonasal orbital surgical procedure and list the relevant anatomic landmarks that will affect surgical planning for biopsy or resection of medial orbital tumors.