Removal of Small Cavernous Hemangioma in Orbital Apex Through an Endoscopic Transethmoidal-Sphenoidal Approach

Objective To investigate the feasibility, efficacy, and safety of an endoscopic transethmoidal-sphenoidal approach in removing a small cavernous hemangioma (CH) located in the deep lateral orbital apex. Methods This study involved 19 patients diagnosed with a CH located in the deep lateral orbital apex. All patients underwent an endoscopic transethmoidal-sphenoidal approach for removal of the CH. The best-corrected visual acuity (BCVA), visual field, and surgery-related complications were analyzed and compared. Results All tumors in this study were completely removed. The mean BCVA was LogMAR 0.97 +/- 0.97 preoperatively and LogMAR 0.38 +/- 0.64 postoperatively (p < 0.05). The mean visual field index was 52.26% +/- 33.26% preoperatively and 75.47% +/- 30.49% postoperatively (p < 0.05). The mean deviation index was -17.48 +/- 12.43 dB preoperatively and -10.10 +/- 10.85 dB postoperatively (p < 0.05), and the pattern standard deviation was 6.37 +/- 3.77 dB preoperatively and 4.90 +/- 3.56 dB postoperatively (p > 0.05). Four (21.1%) patients developed oculomotor limitations and two (10.5%) patients developed ptosis after surgery. All of these symptoms resolved spontaneously, and no other complications occurred. The mean follow-up time was 6.71 +/- 3.89 months. Conclusion The endoscopic transethmoidal-sphenoidal approach is an effective and minimally invasive treatment for removing small CH in the deep lateral orbital apex. Level of Evidence Level 4 Laryngoscope, 2022