189 / 236
Endoscopic OCH resection
in the literature using open techniques.
19,20
Although gen-
eral consensus existed on multiple aspects of the workup
and management of extraconal lesions, several notable ar-
eas of variability existed with respect to intraconal lesions.
These included the laterality and number of hands in the
approach, the methods of medial rectus retraction, and the
need for reconstruction. The increased technical complexity
of addressing intraconal OCHs coupled with their higher
reported postoperative morbidity suggests that continued
research into the optimal management of this subclass of le-
sions is of significant priority. The limitations of this study
include the retrospective nature of the data collection as
well as the modest sample size that precludes any formal
statistical analysis.
Conclusion
Cavernous hemangiomas are among the most common
orbital tumors; however, only 23 cases could be gath-
ered from experienced centers for this international study.
This reflects, in part, the current lack of widespread col-
laboration between oculoplastic and rhinologic surgeons.
Management of intraconal OCHs exhibited the greatest
variability among institutions, suggesting that additional
studies are needed to further optimize the approach to le-
sions in the intraconal space. As a field, we should con-
tinue to work to gain a greater familiarity with endoscopic
surgery of the orbit, create evidence-based protocols for en-
doscopic management of orbital pathology, and cultivate
the development of collaborative “orbital teams.”
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