Various surgical approaches have been applied for treatment of the orbital pathologies. The medial orbital wall is composed mainly of lamina papyracea which could be accessed easily through the ethmoid sinuses. In this article, personal experiences in endoscopic approach to the orbital lesions have been explained.

Three hundred seventy patients with different orbital lesions underwent endoscopic orbital surgery in fifteen years period. A standard anterior and posterior ethmoidectomy were performed in most of cases. In the case of the intact lamina paryracea, it was removed followed by an incision through the periosteum. At the latter stage, much precision was applied to avoid bleeding and ocular muscles injury.

The outcomes were dependent on the type of the lesions. In the benign lesions, complete resection of the tumor was accomplished exclusively endoscopic in most of the cases. Malignant tumors frequently required other therapeutic modalities.

The endoscopic routes have the advantages of being less invasive, excellent homeostasis, time saving and no scars compared to the traditional external approaches. Disadvantages include a steeper learning curve, higher equipment cost and need for an experienced surgeon.