Otolaryngology Perspective

Transorbital surgery came into vogue in 2010 after Kris Moe, an otolaryngologist from Seattle, Washington, published his experience about using an endoscope through small incisions around the orbit. Minimally invasive transorbital portals were subsequently described to access the paranasal sinuses and related skull base spaces. Soon, these new corridors provided access to areas deep within the skull that would ordinarily not only be difficult to reach but would involve tissue destructive approaches that lead to extended periods of morbidity. It took years for these new approaches to be accepted by other disciplines—first neurosurgery, followed by ophthalmology, and more recently, we see maxillofacial surgeons’ interest being piqued. This chapter will aim to guide surgeons, irrespective of their discipline, with regard to decision-making, approaching, and safely managing patients whose lesions can be reached through a minimally invasive transorbital approach. The role of multiportal surgery—combining an endonasal, transorbital, and other keyhole approaches, will be discussed.