Minimally invasive resection of a spheno-orbital tumor: Review of surgical techniques and a case report

Background: Resection of neoplasms of the cranio-orbital region represents a significant surgical challenge due to the extensive spread of the tumor into adjacent anatomical structures, deep regions of the skull base, the dense structure of the tumor, and the complexity of defect reconstruction. The aim of this study is to present a minimally invasive approach, using the example of a spheno-orbital tumor, to evaluate its effectiveness and cosmetic advantages. Case Description: A 46-year-old patient with a spheno-orbital cranial neoplasm presented with exophthalmos and decreased visual acuity (VA 6/18), which had been present for approximately 6 years. A diagnostic evaluation revealed a tumor involving the left greater wing of the sphenoid bone, with extension into the orbit and skull base structures. A notable feature on computed tomography imaging was the inward protrusion of the inner surface of the hyperostotic bone, the lesion had well-defined irregular contours, with remodeling. The patient underwent tumor resection with orbital decompression using a minimally invasive technique. The postoperative period was uneventful, and VA improved on the 1 st postoperative day. The patient was followed for 18 months postoperatively, during which no evidence of residual tumor growth was observed. Conclusion: The presented minimally invasive lateral spheno-orbital approach proved to be safe and cosmetically favorable due to the small incision within the hair-bearing scalp and preservation of the orbital rim. This approach demonstrated good effectiveness in orbital decompression and may be used as a first-stage procedure when a symptom-oriented strategy is sufficient before craniotomy.