The proximity of the orbit to the sinuses has for a long time inspired interest in alternatives to the standard open surgical approaches to the management of orbital disease. Recent advances in endoscopic instruments and techniques have given rise to novel surgical treatments for orbital disease that are safe and may result in less visual morbidity than traditional approaches.
The development of endoscopic approaches for orbital disease has underscored the importance of the relationship between orbital and endoscopic skull base surgeons and the interdisciplinary management that is required to manage these types of patients. It is fitting that this text is edited by an endoscopic skull base surgeon, an orbital surgeon and a head and neck surgeon in order to provide appropriate perspective for the readers.
The text is divided into 20 chapters. These are as follows:
Anatomy of the Orbit and Paranasal Sinuses
Anatomy, Physiology, and Treatment of the Tearing Adult
Radiologic Assessment of the Orbit and Lacrimal System
Evaluation and Management of Congenital Lacrimal Obstruction
Evaluation and Management of Acquired Lacrimal Obstruction
Pathogenesis of Thyroid Eye Disease
Indications and Techniques for Orbital Decompression
Complications or Orbital Decompression and Management
Strabismus and Eyelid Surgery in Thyroid Eye Disease
Orbital Trauma Management, Reconstruction, and External Approaches to the Orbit
Optic Nerve Decompression
Primary Neoplasms of the Orbit
Open Management or Primary Orbital Neoplasms
Endoscopic Management of Primary Orbital Neoplasms
Endoscopic Management of Skull Base Neoplasms with Orbital Involvement
Transorbital Approaches to the Sinuses, Skull Base, and Intracranial Space
Orbital Complications of Sinusitis and Management
Management of Iatrogenic Orbital Injury
Anesthetic Technique for Endoscopic Orbital Surgery
Postoperative Care and Complications Following Open and Endoscopic Orbital Surgery
The text contains 131 excellent illustrations, many of which are in colour and include anatomical schematics, external photos, endoscopic photos, and radiographic images. The images that are in black and white are mostly CT and MRI images and some of the schematics. The text contains 12 tables that provide a good summary or overview of many topics.
The text is set up with a logical flow, starting with the first two chapters that are dedicated to anatomy and physiology. The third chapter then focuses on radiology of the orbit and lacrimal system before delving into evaluation and management of disease.
The rest of the text focuses on specific disease processes. The unique feature of this text is the discussion of both traditional external as well as endoscopic approaches to the surgical management of orbital disease. For example, in the lacrimal discussion, both external and endoscopic dacryocystorhinostomy are described as well as various advantages and disadvantages of each.
Given the prevalence of thyroid disease in the general population, the text includes a comprehensive discussion of thyroid eye disease, its medical and surgical management as well as complications including strabismus and eyelid changes. The next major discussion starts with a review of several important orbital and skull base tumours, followed by descriptions of traditional orbital as well as endoscopic approaches for their management. These chapters provide significant detail about the surgical steps themselves that surgeons of any level can easily follow. These chapters are appropriately followed by a discussion of the complications of sinusitis, its management as well as iatrogenic orbital injuries. Given the advances in minimally invasive surgery, there is also a discussion of special anaesthetic considerations in this setting followed by some general post-operative care information.
The text also comes with online access to the e-book and its additional online media, including video descriptions of several surgical approaches.
This is a timely and well-written text. It provides an excellent framework for surgeons desiring to broaden their scope into endoscopic approaches to orbital disease – some of it themselves, and some in combined skull base-orbital surgery. In this sense, the text fosters the development of interdisciplinary teams to manage complex orbital disease and is a great reference for subspecialty clinicians in orbit, sinus and skull base surgery.