Philosophy/Perspectives by Specialty: The Rhinology Perspective

This chapter discusses the endoscopic transorbital approach from a rhinology perspective. For context, the chapter begins with a review of the historical development of functional endoscopic sinus surgery and, subsequently, endoscopic endonasal skull base surgery which were led and heavily influenced by rhinologists. These advances in endoscopic transnasal surgery were leveraged to provide the foundation on which endoscopic transorbital surgery is based. Limitations in the endoscopic endonasal approaches led to the development of the endoscopic transorbital approaches, and these inherent confines are discussed from the perspective of the rhinologist. The philosophy which underpins use of the endoscopic transorbital approach in rhinology, either as a single surgical portal or in combination with other surgical approaches, is reviewed as is the multidisciplinary surgical team. Lastly, the use of the endoscopic transorbital approach in tackling rhinologic pathology—including mucoceles, cerebrospinal fluid rhinorrhea, and sinonasal tumors—is explored, and several examples are provided.