Transnasal surgery accesses orbital, sinus, or skull-base structures through the nasal cavity using endoscopes and specialised instruments. It avoids external facial incisions while allowing direct approach to deep areas.
Applications
In ophthalmology and ENT, transnasal routes are used for endoscopic dacryocystorhinostomy, orbital decompression, and removal of some tumours or lesions. Collaboration between oculoplastic and rhinology surgeons is common in complex cases.
- High‑definition endoscopy provides close visualisation of nasal and sinus anatomy
- Navigation systems may assist in intricate skull-base work
- Benefits include reduced scarring and potentially quicker recovery
- Not all conditions are suitable; anatomy and disease extent guide selection
Recovery
Post‑operative nasal congestion, crusting, and mild bleeding are expected. Saline rinses and nasal medications help healing and keep the surgical passage open.
- Patients are advised to avoid nose‑blowing, heavy lifting, and flying initially
- Follow‑up endoscopic checks are important to clear crusts and assess healing
- Complications can include infection, CSF leak, or orbital injury but are uncommon in experienced hands
- Careful counselling covers risks and the need for joint specialist care where appropriate
