Removal of Small Cavernous Hemangioma in Orbital Apex Through an Endoscopic Transethmoidal‐Sphenoidal Approach

Objective To investigate the feasibility, efficacy, and safety of an endoscopic transethmoidal‐sphenoidal approach in removing a small cavernous hemangioma (CH) located in the deep lateral orbital apex. Methods This study involved 19 patients diagnosed with a CH located in the deep lateral orbital apex. All patients underwent an endoscopic transethmoidal‐sphenoidal approach for removal of the CH. The best‐corrected visual acuity (BCVA), visual field, and surgery‐related complications were analyzed and compared. Results All tumors in this study were completely removed. The mean BCVA was LogMAR 0.97 ± 0.97 preoperatively and LogMAR 0.38 ± 0.64 postoperatively ( p < 0.05). The mean visual field index was 52.26% ± 33.26% preoperatively and 75.47% ± 30.49% postoperatively ( p < 0.05). The mean deviation index was −17.48 ± 12.43 dB preoperatively and −10.10 ± 10.85 dB postoperatively ( p < 0.05), and the pattern standard deviation was 6.37 ± 3.77 dB preoperatively and 4.90 ± 3.56 dB postoperatively ( p > 0.05). Four (21.1%) patients developed oculomotor limitations and two (10.5%) patients developed ptosis after surgery. All of these symptoms resolved spontaneously, and no other complications occurred. The mean follow‐up time was 6.71 ± 3.89 months. Conclusion The endoscopic transethmoidal‐sphenoidal approach is an effective and minimally invasive treatment for removing small CH in the deep lateral orbital apex. Level of Evidence 4 Laryngoscope , 132:1743–1749, 2022