Applications and Outcomes of Orbital and Transorbital Endoscopic Surgery

Balakrishnan, Karthik; Moe, Kris S.

doi:10.1177/0194599810397285

Cited by 86 publications

(81 citation statements)

References 18 publications

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“…Among possible criticisms from readers, we anticipate anxiety about potential damage to the eye because transorbital procedures are suspected to be associated with major ophthalmologic problems and sequelae. Although such complications are theoretically possible and mean that very careful intraoperative eye management is mandatory, our very extensive experience with orbital decompression in the treatment of Graves disease (>1500 orbits treated) and pertinent reviews in the literature (5,17) reassure us as to the safety of such an approach.…”

Section: Discussionmentioning

confidence: 99%

Multiportal Combined Transorbital Transnasal Endoscopic Approach for the Management of Selected Skull Base Lesions: Preliminary Experience

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Multiportal Combined Transorbital Transnasal Endoscopic Approach for the Management of Selected Skull Base Lesions: Preliminary Experience

et al. 2015

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“…A recent review of 107 cases of orbital and transorbital endoscopic surgery for various pathologies of anterior cranial base showed no complication directly related to surgical approach or use of endoscopy, further validating its safety. 25 Another recent study described transorbital endoscopic repair of CSF leaks. 17 The availability of such a technique further ensures the safety of TONES by allowing expeditious repair if a CSF leak should occur during the management of OCS and ICS.…”

Section: Tones Management Of Epidural Abscessmentioning

confidence: 99%

Transorbital Neuroendoscopic Management of Sinogenic Complications Involving the Frontal Sinus, Orbit, and Anterior Cranial Fossa

et al. 2012

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Transnasal endoscopic surgery has remained at the forefront of surgical management of sinogenic complications involving the frontal sinus, orbit, and anterior skull base. However, the difficulty in accessing certain areas of these anatomical regions can potentially limit its use. Transorbital neuroendoscopic surgery (TONES) was recently introduced to transgress the limits of transnasal endoscopic surgery; the access that it provides could add additional surgical pathways for treating sinogenic complications involving the frontal sinus, orbit, and anterior cranial fossa. We describe a prospective series of 13 patients who underwent TONES for the management of various sinogenic complications, including epidural abscess, orbital abscess, and fronto-orbital mucocele or mucopyocele, as well as subperiosteal abscess presenting with orbital apex syndrome. The primary outcome measurement was the efficacy of TONES in treating these pathologies. TONES provided effective access to the frontal sinus, orbit, and the anterior cranial fossa. All patients demonstrated postoperative resolution of initial clinical symptoms with well-hidden surgical scars. There were no ophthalmologic complications or recurrence of pathology. Based on our experience, TONES appears to provide a valuable addition to the current surgical armamentarium for treating selected complications of sinusitis.

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“…Both patients maintained their baseline ophthalmological exams immediately after surgery. This outcome is not surprising, given that the rate of ophthalmological change is less than 3% for medial transorbital approaches for extracranial indications [5,8] . One patient experienced transient diplopia when watching television that spontaneously resolved.…”

Section: Discussionmentioning

confidence: 93%

“…The medial transorbital approach has been described in several clinical series for the repair of CSF leaks and skull base fractures, optic nerve decompression, and resection of extra-axial tumors [5,8] . Previously, we [7] and others [9] have demonstrated the feasibility of a lateral transorbital approach to the intracranial space in cadaveric specimens.…”

Section: Discussionmentioning

confidence: 99%

Lateral Transorbital Endoscopic Access to the Hippocampus, Amygdala, and Entorhinal Cortex: Initial Clinical Experience

Chen¹,

Bohman²,

Emery³

et al. 2015

ORL

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Background/Aims: Transorbital approaches traditionally have focused on skull base and cavernous sinus lesions medial to the globe. Lateral orbital approaches to the temporal lobe have not been widely explored despite several theoretical advantages compared to open craniotomy. Recently, we demonstrated the feasibility of the lateral transorbital technique in cadaveric specimens with endoscopic visualization. We describe our initial clinical experience with the endoscope-assisted lateral transorbital approach to lesions in the temporal lobe. Methods: Two patients with mesial temporal lobe pathology presenting with seizures underwent surgery. The use of a transpalpebral or Stallard-Wright eyebrow incision enabled access to the intraorbital compartment, and a lateral orbital wall 'keyhole' opening permitted visualization of the anterior temporal pole. Results: This approach afforded adequate access to the surgical target and surrounding structures and was well tolerated by the patients. To the best of our knowledge, this report constitutes the first case series describing the endoscope-assisted lateral transorbital approach to the temporal lobe. We discuss the limits of exposure, the nuances of opening and closing, and comparisons to open craniotomy. Conclusion: Further prospective investigation of this approach is warranted for comparison to traditional approaches to the mesial temporal lobe.

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Applications and Outcomes of Orbital and Transorbital Endoscopic Surgery

Abstract: Orbital and transorbital endoscopy are versatile, effective, and safe approaches useful for addressing diverse urgent and elective problems. In appropriate clinical situations, these procedures may offer better access and visualization than open or transnasal approaches.

Cited by 86 publications

References 18 publications

Multiportal Combined Transorbital Transnasal Endoscopic Approach for the Management of Selected Skull Base Lesions: Preliminary Experience

Multiportal Combined Transorbital Transnasal Endoscopic Approach for the Management of Selected Skull Base Lesions: Preliminary Experience

Transorbital Neuroendoscopic Management of Sinogenic Complications Involving the Frontal Sinus, Orbit, and Anterior Cranial Fossa

Lateral Transorbital Endoscopic Access to the Hippocampus, Amygdala, and Entorhinal Cortex: Initial Clinical Experience

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