{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T17:15:43Z","timestamp":1776705343875,"version":"3.51.2"},"reference-count":12,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Cavernous Hemangioma Exclusively Endonasal Resection (CHEER) staging system has become the gold standard for outcomes reporting in endoscopic orbital surgery for orbital cavernous hemangiomas (OCHs). A recent systematic review demonstrated similar outcomes between OCHs and other primary benign orbital tumors (PBOTs). Therefore, we hypothesized that a simplified and more comprehensive classification system could be developed to predict surgical outcomes of other PBOTs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patient and tumor characteristics as well as surgical outcomes from 11 international centers were recorded. All tumors were retrospectively assigned an Orbital Resection by Intranasal Technique (ORBIT) class and stratified based on surgical approach as either exclusively endoscopic or combined (endoscopic and open). Outcomes based on approach were compared using chi\u2010squared or Fisher's exact tests. The Cochrane\u2010Armitage test for trend was used to analyze outcomes by class.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Findings from 110 PBOTs from 110 patients (age 49.0\u00a0\u00b1\u00a015.0 years, 51.9% female) were included in the analysis. Higher ORBIT class was associated with a lower likelihood of gross total resection (GTR). GTR was more likely to be achieved when an exclusively endoscopic approach was utilized (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). Tumors resected using a combined approach tended to be larger, to present with diplopia, and to have an immediate postoperative cranial nerve palsy (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endoscopic treatment of PBOTs is an effective approach, with favorable short\u2010term and long\u2010term postoperative outcomes as well as low rate of adverse events. The ORBIT classification system is an anatomic\u2010based framework that effectively facilitates high\u2010quality outcomes reporting for all PBOTs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23141","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T23:14:28Z","timestamp":1676675668000},"page":"1852-1863","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Orbital resection by intranasal technique (ORBIT): A new classification system for reporting endoscopically resectable primary benign orbital tumors"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5254-3221","authenticated-orcid":false,"given":"Aria","family":"Jafari","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nithin D.","family":"Adappa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania School of Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent J.","family":"Anagnos","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania School of Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raewyn G.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Science Macquarie University  Sydney New South Wales Australia"},{"name":"Department of Otorhinolaryngology Head and Neck Surgery Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Castelnuovo","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology Department of Biotechnology and Life Sciences University of Insubria Ospedale di Circolo e Fondazione Macchi  Varese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ara","family":"Chalian","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania School of Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher B.","family":"Chambers","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandala","family":"Chitguppi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iacopo","family":"Dallan","sequence":"additional","affiliation":[{"name":"Ear, Nose, Throat (ENT) Unit Azienda Ospedaliera Universitaria Pisana  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"El Rassi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Oklahoma Health Sciences Center  Oklahoma City Oklahoma USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne K.","family":"Freitag","sequence":"additional","affiliation":[{"name":"Ophthalmic Plastic Surgery Service Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan C.","family":"Fernandez Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Stanford University  Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Manuel","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Gudis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Science Macquarie University  Sydney New South Wales Australia"},{"name":"Rhinology and Skull Base Research Group Applied Medical Research Centre University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Beijing Tongren Hospital Capital Medical University Key Laboratory of Otolaryngology\u2013Head &amp; Neck Surgery Ministry of Education  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6832-754X","authenticated-orcid":false,"given":"Ian M.","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania School of Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Y. K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0489-0181","authenticated-orcid":false,"given":"Ashton E.","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Geisinger Medical Center  Danville Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Locatelli","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery Department of Biotechnology and Life Sciences Ospedale Di Circolo E Fondazione Macchi University of Insubria  Varese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kibwei A.","family":"McKinney","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Oklahoma Health Sciences Center  Oklahoma City Oklahoma USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annie","family":"Moreau","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Oklahoma  Oklahoma City Oklahoma USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gurston","family":"Nyquist","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James N.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania School of Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narayanan","family":"Prepageran","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Faculty of Medicine Universiti Malaya Jalan Universiti Wilayah Persekutuan  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund A.","family":"Pribitkin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mindy R.","family":"Rabinowitz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc R.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Sacks","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Science Macquarie University  Sydney New South Wales Australia"},{"name":"Department of Otolaryngology\u2013Head &amp; 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