Transnasal surgery of the orbita

The endonasal surgery has a branch in the transnasal orbital surgery. For t his transnasal approach the anterior skull base, the medial and infero-medi al orbita,the orbital apex with the optical nerve and the sphenoid sinus a re with in reach. In all primary a nd secondary malignant lesions with exte nsion into the orbita, the transnasal biopsy is of importance for diagnosis , particularly in metastasis to the orbit and pseudo-tumors. Benign lesions like mucoceles and osteomas are accessible and fully removable. Good resul ts have been obtained in endonasal orbital decompression and inhomogeneous space occupying intraorbital lesions like bleedings. Among the orbital trau matism, with restrictions fractures of the medial orbital wall, medial orbi tal floor and foreign bodies could be operated. The transnasal approach is not indicated in all diseases,which are situated mostly intraconally, supra orbitally and lateral of the bulbus as well as in tumors with intracranial extension. In summary, the transnasal orbital approach has its place as hel pful addition to the transfacial and transcranial techniques and can even r eplace them in certain selected indications.