Endonasal endoscopic resection of an orbital cavernous hemangioma: a case report

Orbital cavernous hemangiomas are benign vascular tumors commonly found in adults but are rarely managed by otolaryngologists. Advances in endoscopic technology have expanded the use of endonasal endoscopic surgery for intraorbital lesions, providing minimal invasiveness and excellent cosmetic outcomes. We report the case of a 47-year-old woman with decreased vision in the left eye due to a cavernous hemangioma in the posteroinferior orbit. The tumor was completely resected via a bilateral transnasal endoscopic approach using the endoscopic modified medial maxillectomy technique and the transseptal access with crossing multiple incisions techniques, with minimal bleeding and preservation of visual function. Postoperative recovery was favorable, with improved vision and no recurrence at 6 months. The endonasal approach is particularly effective for lesions situated medial to the optic nerve, at the orbital apex, or in the inferomedial region and is considered the preferred method depending on tumor localization at preoperative diagnosis.