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ASOHNS ASM 2026
Design and Evaluation of Purpose-Built Instruments for Endoscopic Endonasal Intraorbital Surgery: A Pilot Study
Poster

Poster

Themes

ASOHNS

Presentations Description

Institution: Prince of Wales Hospital - New South Wales, Australia

Background: Endoscopic orbital surgery represents an emerging frontier at the intersection of otolaryngology, neurosurgery, and oculoplastic surgery. Although imaging and navigation have advanced rapidly, development of dedicated instruments has lagged. This study presents the first purpose-built instrument set designed specifically for the endoscopic endonasal intraorbital corridor, evaluated in a multidisciplinary cadaveric setting. Methodology: Eight novel prototype instruments (four dissectors, four retractors) were designed in collaboration with the Tyree Foundation Institute of Health Engineering, UNSW, Sydney. Each was assessed by otolaryngologists, neurosurgeons and oculoplastic surgeons in cadaveric dissections under endoscopic visualisation. Instruments were scored across six predefined domains using a 10-point Likert scale. Data was analysed using a linear mixed-effects model incorporating instrument type, subspecialty, and years of experience. Results: Across all domains, dissectors significantly outperformed retractors (mean 5.69 ±1.10 vs 2.49 ± 0.50; mean difference 3.20; p < 0.001). The “Freer short 8 mm” and “Olive-tip” dissectors achieved the highest overall ratings (mean 6.23 ±1.26 and 6.67 ± 1.35, respectively), demonstrating superior ergonomics and manoeuvrability. No significant inter-specialty variability was identified. Mid-career surgeons provided the highest mean ratings (4.74 ± 1.33). Conclusion: This pilot study provides the first structured evaluation of instruments purpose-built for endoscopic endonasal orbital surgery. Dissector prototypes consistently outperformed retractors across all measured domains, suggesting that tailored geometry improves precision and control within the intraconal space. These early-phase data support further refinement and staged evaluation of dedicated endonasal orbital instruments for possible clinical use.
Speakers
Authors
Authors

Dr Surya Singh - , A/Prof Geoff Wilcsek - , Dr Catherine Banks -