Rhinosurgery in diseases of the orbits

: The rhinosurgical procedures in different orbital diseases are discussed. Special attention is directed to the application of endoscopic and microsurgical techniques. We describe the different stages of orbital involvement in 106 patients. Computer-tomography has proven to be most effective informing the extent of sinus disease as well as orbital inflammation, because of this an immediate stage-dependent therapy can be commenced. Indications for endonasal, extranasal or for combined approaches are given. In two patients with blindness due to mycosis we performed an exenteration of the orbit. The advantages of extranasal and endonasal techniques for decompression of the orbit are discussed. Successful approaches for the extranasal microsurgical removal of orbital tumors are described. The results demonstrate that the surgically decompressed optic nerve has a favourable prognosis. Pathogenesis, diagnostic procedures, indications and microsurgical techniques of the traumatized optic nerve are discussed. The long-term follow up results of our optic nerve decompression cases are presented.