ENDOSCOPIC MANAGEMENT OF ORBITAL APEX LESIONS

Lesions of the orbital apex often present a diagnostic dilemma. Clinic al assessment and imaging studies are helpful but a tissue biopsy is o ften required. The morbidity associated with transcranial approaches t o the orbital apex: may outweigh the benefits of obtaining a biopsy by these routes. Fine needle aspiration cytology of orbital apex lesions can be performed bus there are disadvantages with this method. We des cribe a transnasal endoscopic technique to biopsy the orbital apex. Th e technique was used successfully to obtain a tissue diagnosis in six patients with orbital apex lesions. This enabled commencement of defin itive treatment. There were no significant complications. The transnas al approach to the orbital apex using the endoscopes is reliable. Endo scopes provide excellent illumination, magnification, and a panoramic view of the operative field.