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Augmented-reality template guided transorbital approach for intradural tumors

Walter C. Jean, Kenneth D. Sack, and Andrew R. Tsen

Transcript This video demonstrates the technique of using augmented reality templates to guide the transorbital approach for intradural tumors. 1–3 For a “minimally invasive” approach to a deep-lying skull base lesion, the bone opening must be small yet provide adequate exposure to the surgical target. Surgical rehearsal in virtual reality (VR) can reveal the nuances of patient-specific anatomy and simultaneously generate navigation-integrated augmented reality templates to ensure precise surgical openings. 4 , 5 To do this, three

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Lateral transorbital approach: an alternative microsurgical route for supratentorial cerebral aneurysms

Murat Ulutas, Kadir Çinar, Ihsan Dogan, Mehmet Secer, Semra Isik, and Kaya Aksoy

T he transorbital approaches defined for aneurysm surgery are modifications of supraorbital mini craniotomy, which comprise a craniotomy with an additional superior orbital wall removal. 1 , 5 , 15–17 Anatomical and clinical studies of the endoscopic transorbital approaches to the intracranial pathologies were reported. 2 , 7–9 , 11 , 14 Although the number of anatomical studies on endoscopic transorbital approaches is increasing, only limited results of clinical experiences have been published. 2 , 7 , 8 , 11 The previously defined and well-known lateral

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Surgery for orbital tumors. Part II: transorbital approaches

Kimberley P. Cockerham, Ghassan K. Bejjani, John S. Kennerdell, and Joseph C. Maroon

Orbital tumors can be excised or biopsy samples obtained via transorbital approaches, especially those located in the anterior two thirds of the orbit. The indications and various surgical steps will be reviewed for the anterior, the anteromedial, and the lateral approaches. Some of these approaches can be combined or extended to accommodate large or deep-seated tumors.

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Extended endoscopic transorbital approach with superior-lateral orbital rim osteotomy: cadaveric feasibility study and clinical implications (SevEN-007)

*Jaejoon Lim, Kyoung Su Sung, Woohyun Kim, Jihwan Yoo, In-Ho Jung, Seonah Choi, Seung Hoon Lim, Tae Hoon Roh, Chang-Ki Hong, and Ju Hyung Moon

S ince the introduction of the endoscopic transorbital approach (ETOA), the areas in which surgical treatment is possible with this method have been expanded in the course of several studies. 1–3 Anterior petrosectomy in the posterior fossa area was possible with ETOA, and a new method to access lesions in the insular region via the ETOA has also been reported. 4–6 Additional research has also been conducted to efficiently use the surgical space by modifying the ETOA with insertion of a small port. 7 , 8 In particular, it was observed that even a little

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Transorbital approach for endoscopic repair of encephalocele

Christina E. Sarris, Griffin D. Santarelli, and Andrew S. Little

Transcript We will be demonstrating a transorbital approach for endoscopic repair of an anterior skull base encephalocele. The patient is a 77-year-old man with a 2-year history of left-sided nasal drainage. The drainage had a salty, metallic taste and was confirmed beta-2 transferrin positive. He had no prior craniofacial trauma or sinus surgery. His past medical history was significant for obesity, obstructive sleep apnea, and hemidiaphragm paralysis. He had a normal physical exam, including nasal endoscopy. CT of the head demonstrated thinning and erosion of

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Endoscopic transorbital approach bone pillars: a comprehensive stepwise anatomical appraisal

Marta Codes, Alejandra Mosteiro, Roberto Tafuto, Lorena Gomez, Jessica Matas, Isam Alobid, Mauricio Lopez, Alberto Prats-Galino, Joaquim Enseñat, and Alberto Di Somma

I n recent years, transorbital surgery has garnered considerable consideration and gained popularity. 1 – 19 The notable evolution of this technique underscores the significance of detailed anatomical knowledge and clinical experience. These factors are instrumental in refining the procedure and broadening its indications within the armamentarium of skull base neurosurgeons. 20 – 27 We propose retaining the previously described phases for the endoscopic superior eyelid transorbital approach, namely the 1) skin, 2) working space, 3) lesion removal, and 4

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Endoscopic endonasal and transorbital approaches to petrous apex lesions

Won Jae Lee, Sang Duk Hong, Kyung In Woo, Ho Jun Seol, Jung Won Choi, Jung-Il Lee, Do-Hyun Nam, and Doo-Sik Kong

been investigated in many studies, 11 , 13 , 14 , 16 , 19–22 and Scopel et al. proposed a clinical-surgical classification of PA. 15 They divided PA into three zones according to its relationship with ICA, which is a key element in determining expansion of EEA. ICA is considered the most critical structure that limits accessibility to PA via EEA. 13 , 19 , 23 More recently, an alternative endoscopic surgical route to PA, the endoscopic transorbital approach (TOA), was proposed to overcome this challenge. 19 , 23 , 24 TOA can provide the same surgical window as

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Endoscopic transorbital approach in children: surgical technique and early results

Chiman Jeon, Kyuha Chong, Hyung Jin Shin, and Doo-Sik Kong

O ver the past 2 decades, skull base surgery has transitioned from maximally invasive to minimally invasive techniques. Recently, the endoscopic transorbital approach (ETOA) has emerged as a paramedian skull base operative corridor for accessing various anterior and middle skull base pathologies, particularly lateral to the parasellar and paraclival internal carotid artery. 1 – 11 Unlike the endoscopic endonasal approach (EEA), the ETOA provides a coplanar endoscopic keyhole trajectory that courses through the orbit, affording optimal visualization

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Endoscopic transorbital approach to the insular region: cadaveric feasibility study and clinical application (SevEN-005)

Eui Hyun Kim, Jihwan Yoo, In-Ho Jung, Ji Woong Oh, Ju-Seong Kim, Jin Sook Yoon, Ju Hyung Moon, Seok-Gu Kang, Jong Hee Chang, and Tae Hoon Roh

resection is the middle cerebral artery (MCA) and its branches. In particular, injury of the long insular perforating arteries is frequently associated with infarction in the corona radiata, which results in serious contralateral motor dysfunction. 8 The endoscopic transorbital approach (ETOA) is an emerging surgical corridor for accessing not only various skull base areas but also brain parenchymal regions. 9 , 10 We noted the possibility that the insular region can be approached more safely by an anteroposterior corridor under ETOA. Using cadaveric specimens, we

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The biportal transorbital approach: quantitative comparison of the anterior subfrontal craniotomy, bilateral transorbital endoscopic, and microscopic approaches

Lena Mary Houlihan, Thanapong Loymak, Irakliy Abramov, Jubran H. Jubran, Ann J. Staudinger Knoll, Jacob T. Howshar, Michael G. J. O’Sullivan, Michael T. Lawton, and Mark C. Preul

associated with endonasal surgical intervention include nasal morbidity, CSF leaks, CSF fistulas, meningitis, and vascular injury. 10 – 12 Although transorbital neuroendoscopic surgery (TONES) is still in its infancy, there is an increasing body of clinical evidence that TONES is associated with a low risk of adverse outcomes. 13 , 14 No studies have explored the anatomical accessibility, surgical benefits, and disadvantages of a biportal bilateral transorbital approach. In this study, our goal was to quantitatively scrutinize this transorbital route with an open