This video describes a combined surgical approach to inferomedial tumors of the orbital apex. This approach is most effective for inferomedial apex lesions. It is not recommended for lesions located above or lateral to the optic nerve. Based on their experience with 3 patients, the authors say this technique offers a number of advantages, including increased visualization of the orbital apex, medial prolapse of the lesion and additional counter traction for dissection through an endonasal approach, and it’s within the scope of an oculofacial surgeon.