How to Perform Approaches of the Orbit

Abstract

There are several types of tumorous or pseudo-tumorous lesions affecting the orbit. The first historical stage was to make a coherent nosological approach of it. Often confused with the diagnosis and the treatment of tumorous proptosis, the first descriptions of tumors of the optical pathways and the optic nerve sheath are due to Antonio Scarpa (1816), who described a tumor of the optic nerve. Similarly, Jean Cruveilhier (1835) considered that meningiomas are tumors which do not belong to the central nervous system itself and must be distinguished from it. Albrecht von Graefe applied the same principle to tumors of the optic nerve. A. C. Hudson (1912) considered meningiomas of the optic nerve sheath as being separate from tumors of the optic nerve itself. However, it was Harvey Cushing [4], who provided the first accurate description of meningiomas as he distinguished meningiomas according to their origin from the arachnoid mater. He therefore dissociated orbito-sphenoidal meningiomas spreading the orbital content from meningiomas affecting the optic nerve sheath.