Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington, USA.
Otolaryngol Head Neck Surg. 2011 May;144(5):815-20. doi: 10.1177/0194599810397285.
To prospectively evaluate the safety, effectiveness, and utility of orbital and transorbital endoscopic surgery.
Case series with planned data collection.
Level 1 trauma center and tertiary academic hospital.
Consecutive sample of 107 patients undergoing orbital or transorbital endoscopic operations.
Ability to achieve intraoperative goals using endoscopic approach; occurrence of predetermined intraoperative or postoperative complications.
One hundred seven patients (aged 6-83 years) underwent orbital or transorbital endoscopic surgery for 6 different indications. Seven incisions were used. Endoscopic orbitotomies were made through all 4 orbital walls to access surrounding structures. Intraoperative goals were achieved endoscopically in 106 patients. Mean follow-up was 3 months (mean ± SD, 3.0 ± 3.5). No complication was directly related to surgical approach or use of endoscopy. Seventeen complications were detected in 2 categories: persistent diplopia and persistent vision change. No patient had vision loss. No nonfracture patient suffered a complication. Subgroup analysis demonstrated no difference in surgical success rates when compared with transnasal and transantral medial orbital wall and orbital floor repair and cerebrospinal fluid leak repair. Endoscopic visualization was advantageous in several respects: superior visualization and lighting, particularly posterior to the equator of the globe; image magnification; and video monitoring for education and operating room staff involvement. It also facilitated surgical navigation and computer-aided reconstruction.
Orbital and transorbital endoscopy are versatile, effective, and safe approaches useful for addressing diverse urgent and elective problems. In appropriate clinical situations, these procedures may offer better access and visualization than open or transnasal approaches.
前瞻性评估眼眶和经眶内窥镜手术的安全性、有效性和实用性。
有计划数据收集的病例系列。
1 级创伤中心和三级学术医院。
连续样本 107 例接受眼眶或经眶内窥镜手术的患者。
使用内窥镜方法实现术中目标的能力；发生预定的术中或术后并发症。
107 例患者（年龄 6-83 岁）因 6 种不同适应证接受眼眶或经眶内窥镜手术。使用了 7 个切口。通过所有 4 个眼眶壁进行内窥镜眶切开术，以进入周围结构。106 例患者经内窥镜实现了术中目标。平均随访 3 个月（均值±SD，3.0±3.5）。没有并发症与手术方法或内窥镜使用直接相关。2 类中检测到 17 种并发症：持续性复视和持续性视力改变。没有患者视力丧失。没有非骨折患者发生并发症。亚组分析表明，与经鼻和经眶内侧壁和眶底修复以及脑脊液漏修复相比，手术成功率无差异。内窥镜可视化在几个方面具有优势：优越的可视化和照明，特别是在眼球赤道的后部；图像放大；以及视频监测，用于教育和手术室工作人员参与。它还促进了手术导航和计算机辅助重建。
眼眶和经眶内窥镜是一种多功能、有效且安全的方法，可用于解决各种紧急和择期问题。在适当的临床情况下，这些手术可能比开放或经鼻入路提供更好的进入和可视化。
