The Keyhole orbitotomy
Author: Allan Pieroni-Goncalves
Base Hospital / Institution: University of Sao Paulo Medical School
Video presentation
Abstract ID: 25-465
Purpose
To demonstrate a minimally invasive lateral orbitotomy in a surgery of cavernous hemangioma excision.
Methods
We show a video of a case of a 35-year-old patient presenting with left proptosis caused by an intraconal cavernous hemangioma. The vascular lesion was positioned lateral and superior to the optic nerve, measuring approximately 16 mm in diameter. Due to its size and location, the typical surgical approach is via a lateral osseous orbitotomy. Because the tumor is vascular and can be partially decompressed through aspiration, a small debulking of the lateral wall margin can be performed, facilitating lesion excision with safe intraoperative control and a reduced operative time.
Results
The surgery was performed quickly and with minimal invasiveness. The keyhole orbitotomy approach provided safe intraoperative management and allowed for effective handling of the intraorbital lesion.
Conclusion
The minimally invasive keyhole orbitotomy offers significant advantages in the management of orbital cavernous hemangiomas, which are common intraorbital lesions. This approach allows for safer and more controlled excision while minimizing tissue disruption and surgical morbidity. Additionally, the tumor’s vascular nature permits partial decompression through bleeding maneuvers, facilitating easier removal and reducing operative time. Overall, this technique provides an effective, less invasive alternative to traditional approaches, promoting better recovery and preserving orbital structures.
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