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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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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

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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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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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Endoscopic transorbital approach to the infratemporal fossa and parapharyngeal space: a cadaveric study

Mina M. Gerges, Saniya S. Godil, Iyan Younus, Michael Rezk, and Theodore H. Schwartz

important anatomical landmark during transorbital endoscopic approaches to the skull base ( Fig. 1 ). The IOF lies in the orbital floor in proximity to the middle cranial fossa, foramen rotundum, pterygopalatine fossa, ITF, and temporal fossa. 12 The objective of this study was to establish a transorbital endoscopic approach to utilize the IOF to gain access to the ITF and provide a detailed endoscopic anatomical description of the ITF achieved with this approach. FIG. 1. Different segments of the lateral orbital wall demonstrating the relationship between the middle

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Endoscopic transorbital superior eyelid approach: anatomical study from a neurosurgical perspective

Alberto Di Somma, Norberto Andaluz, Luigi Maria Cavallo, Matteo de Notaris, Iacopo Dallan, Domenico Solari, Lee A. Zimmer, Jeffrey T. Keller, Mario Zuccarello, Alberto Prats-Galino, and Paolo Cappabianca

connected to a video monitor; images were captured using a high-definition digital video system (Stryker). Specimens were positioned supine, pinned, and fixed in a Mayfield head holder, rotated 5° laterally to the contralateral side ( Fig. 1 ). A skin incision was placed in the superior eyelid crease, above the tarsal plate. A high-speed drill was used for bone removal. Fig. 1. Stepwise dissection of the superior eyelid endoscopic transorbital approach (left side). The head is slightly rotated to the contralateral side. After positioning, tarsorrhaphy is performed, and a

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Transorbital endoscopic eyelid approach for resection of sphenoorbital meningiomas with predominant hyperostosis: report of 2 cases

João Paulo Almeida, Sacit B. Omay, Sathwik R. Shetty, Yu-Ning Chen, Armando S. Ruiz-Treviño, Buqing Liang, Vijay K. Anand, Benjamin Levine, and Theodore H. Schwartz

portion of the orbit and inferomedial components of SOMs that may enter into the infratemporal fossa and lateral sphenoid sinus. 13–15 , 39 , 50 , 52 However, resection of lateral skull base lesions, such as lateral sphenoid meningiomas, remains one of the major limitations of the endoscopic endonasal approach. Recently, a multiportal transorbital and endonasal approach has been proposed as a new minimally invasive option to reach the lateral orbit and middle fossa. 20 , 22 , 41 These approaches are particularly suited for patients with predominant hyperostosis and

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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 transorbital keyhole approach: early and long-term outcome analysis of approach-related morbidity and cosmetic results

Technical note

Kerim Beseoglu, Sabrina Lodes, Walter Stummer, Hans-Jakob Steiger, and Daniel Hänggi

A variety of approaches to the frontal cranial base for aneurysms of the ACoA have been described over the last years. Lately, smaller approaches have been favored due to better cosmetic results and fewer approach-related complications. In general, many of these minimally invasive approaches are variations of orbitozygomatic, pterional, or supraorbital approaches. 11 , 12 In 2001, we proposed a minimally invasive transorbital keyhole approach especially for ACoA aneurysms. 18 The approach was regarded as a step toward the ideal of purely extraaxial and

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Use of endoscopic transorbital and endonasal approaches for 360° circumferential access to orbital tumors

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

endonasal approach (EEA) according to its corresponding clock position relative to the optic nerve. 3 On the other hand, since Moe et al. first introduced a pure endoscopic transorbital surgery for anterior skull base lesions based on the four quadrants around the orbit, the endoscopic transorbital superior eyelid approach (ETOA) as well as the EEA has been emerging as a minimally invasive alternative to open transcranial approaches for orbital pathologies. 5 , 6 Although the ETOA offers a direct route to skull base lesions involving the orbital apex, middle