gms | German Medical Science

Histopatological diagnosis of the intraorbital tumors is of crucial value for planning further therapy. The aim of the study was to explore clinical utility of image-guided endoscopy for orbital tumors biopsy.

We present the group of patients with intraorbital mass lesions in whom transnasal endoscopic biopsy was performed using a videooptic (Medtronic Stealth Station Treon plus) and electromagnetic (Medtronic Fusion ENT Navigation) neuronavigation systems. The CT and MRI 1 mm slice images were fused by the system in order to visualize both bony and soft tissue structures. The anatomic pair point registration protocol and surface matching technique were used during the procedure.

All lesions were precisely localized and the biopsy was taken from the representative part of the pathological mass. The technique proved to be particularly advantageous in cases with small, medially localized, retrobulbar tumors and in unclear situations when the structure of the lesion resembled surrounding intraorbital tissue. The precision of the neuronavigation system enabled keeping the operative corridor as well as the size of orbital wall fenestration very narrow minimizing intraoperative trauma. None of the patients developed ocular symptoms aggravation after the procedure. The accuracy of neuronavigation remained high and stable during the entire procedure.