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Endoscopic Endonasal Approaches to the Orbit

Sinus surgery was once thought to be ineffective with morbidity risks outweighing the potential benefits of surgery. However, the field was revolutionized with the introduction of the rigid endoscope in 1985.1 Today, functional endoscopic sinus surgery is an essential component in the management of inflammatory, benign, andmalignant sinonasal pathologies. Improved visualization in endoscopic surgery combined with powered instrumentation has allowed for development of techniques improving the safety and efficacy of surgery. It also allowed for novel surgical approaches, which previously required a skin incision with morbid and disfiguring results and an extensive recovery period. These advances have provided otolaryngologists with an armamentarium of techniques to surgically address rhinologic pathologies, but also those involving the skull base and the orbit. The following endoscopic approaches to the orbit to be discussed include dacryocystorhinostomy (DCR), orbital wall decompression, optic nerve decompression, superior orbital fissure decompression, and excision of intraorbital tumors.