Transorbital endoscopic approaches: Applications in orbital surgery

Transorbital endoscopic approaches (TEAs) for orbital surgery have gained considerable traction since the concept was first formalized approximately 2 decades ago. While the distinction in the nomenclature between TEAs and transorbital neuroendoscopic surgery can be at times ambiguous, this review focuses exclusively on TEAs for primary orbital pathology. The current literature on TEAs encompasses preclinical cadaveric dissection studies, clinical case reports and case series. Orbital roof lesions accessed via a superior lid crease incision to enter the subperiosteal space predominated in the early literature. Since then, TEAs have expanded to orbital lesions within both the extraconal and intraconal spaces, and the orbital apex. Clinical series thus far have reported favorable outcomes, with a low risk of permanent functional sequelae. We discuss the advantages and limitations of TEAs.