Comparative Clinical Outcomes of Different Orbitotomy Approaches in the Surgical Management of Orbital Tumors.

Abstract

Background: Optimal surgical management of orbital tumors requires precise selection of the surgical approach to achieve complete tumor removal while preserving visual function and maintaining cosmetic outcomes.

Objective: This study aimed to evaluate and compare the clinical outcomes of different orbitotomy approaches-including lateral, inferior, supraorbital, and endoscopic endonasal techniques-in the surgical management of orbital tumors.

Methods: A retrospective single-center study was conducted on 68 patients (36 men and 32 women; mean age: 42.1 ± 14.3 years) who underwent surgical treatment for orbital tumors between 2018 and 2024. Preoperative evaluation included comprehensive ophthalmologic examination, CT and MRI imaging, and histopathological confirmation. The choice of surgical approach was guided by tumor location: lateral orbitotomy (n = 17), inferior orbitotomy (n = 21), supraorbital orbitotomy (n = 14), and endoscopic endonasal approach (n = 16). Continuous variables are presented as mean ± SD. Paired t-tests and χ ² tests were used for statistical analysis, with p < 0.05 considered statistically significant.

Results: Visual acuity and ocular motility were preserved in 65 of 68 patients (95.6%). Mean postoperative orbital volume at six months was 26.31 ± 1.28 mL on the operated side and 25.71 ± 1.82 mL on the contralateral side, with no significant difference (p > 0.05). Globe projection differences were < 2 mm in 94.1% of patients. Postoperative complications were minimal, with only a few cases of transient diplopia.

Conclusion: Selection of orbitotomy approach based on tumor localization allows safe and effective surgical management of orbital tumors. Both traditional and minimally invasive approaches can provide favorable functional and cosmetic outcomes when applied according to anatomical indications.