Endoscopic Transorbital Superior Eyelid Approach for the Management of Selected Spheno-orbital Meningiomas: Preliminary Experience

Dallan, Iacopo; Sellari–Franceschini, Stefano; Turri‐Zanoni, Mario; Notaris, Matteo de; Fiacchini, Giacomo; Fiorini, Francesca Romana; Battaglia, Paolo; Locatelli, Davide; Castelnuovo, Paolo

doi:10.1093/ons/opx100

Cited by 71 publications

(71 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6,8,12 Dallan et al reported proptosis to be the most common presenting symptom (100% of their cases), while 42.8% presented with visual impairment. 16 Our findings could be explained by the delayed presentation, extended duration of symptoms, extensive disease, and large number (52%) of patients with intraorbital tumor extension.…”

Section: Discussionmentioning

confidence: 65%

“…The tumor volume removed as measured by CT scan ranged between 55 and 100%. 16 Proptosis is caused by tumor infiltration of bone resulting in a hyperostotic reaction of the sphenoid wing. Hyperostosis displaces the globe from medially and by mass effect may stretch the optic nerve and has the potential to compromise vision.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there is a lack of published data in the English literature regarding the level of reduction in proptosis, visual improvement and gross-total resection achieved in patients that have undergone the above procedure for sphenoid wing meningiomas. 16 This study retrospectively determined the extent of reduction in proptosis, as well as the improvement in visual outcomes in patients routinely undergoing a minimally invasive endoscopic transorbital approach for the treatment of sphenoid wing meningiomas. Most of the patients underwent initial multiportal surgery in an attempt to salvage vision and reduce proptosis while awaiting a craniotomy as definitive surgery for resection of the intracranial component.…”

Section: Resection Of the Orbital Component Through The Lateralmentioning

confidence: 99%

“…Thus, complete surgical resection is challenging, associated with an increased risk of postoperative complications, high residual tumor, and recurrence rates postsurgery. 16 Tumors that partly encase or invade multiple cerebral vessels are not resectable and have an increased risk of postoperative cerebrovascular accident. 15 The Simpson grading system is typically used as the standard for grading tumor resection.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Transorbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and Surgical Technique

Gonçalves

Lubbe

2020

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

Sphenoid wing meningiomas are benign tumors that can result in proptosis, visual impairment, and pain. Traditional open surgical approaches are associated with significant morbidity. Transorbital endoscopic surgery has been developed as a minimally invasive approach to gain access to these tumors and address the main presenting symptoms. Case series reporting transorbital endoscopic resection of sphenoid wing meningiomas using combined endonasal, pre-caruncular, and extended superior eyelid approaches have demonstrated stable and/or improved short- and medium-term visual outcomes. Earlier medial optic nerve decompression appears to result in more favorable long-term visual outcomes. Transorbital endoscopic surgery therefore represents an emerging minimally invasive alternative to deal with these challenging lesions.

show abstract

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Resection Of the Orbital Component Through The Lateralmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transorbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and Surgical Technique

Gonçalves

Lubbe

2020

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

show abstract

“…In the era of neuroendoscopic surgery, an endoscopic transorbital approach (eTOA) through the superior eyelid crease has been proposed as a viable way to access anterior and middle cranial fossa lesions such as spheno-orbital meningioma. 3,5,13,22,26,28,41,43 In addition to the visualization of cranio-orbital tumors, a surgical corridor through this approach allows excellent visualization of the lateral cavernous sinus while avoiding the need for brain retraction. 9-13, 15, 26, 28, 34,35 Recent cadaveric studies have suggested that this approach allows direct access to Meckel's cave without disruption of the temporalis muscle, and craniotomy and has been emerging as a complementary route for accessing Meckel's cave.…”

mentioning

confidence: 99%

Endoscopic transorbital surgery for Meckel’s cave and middle cranial fossa tumors: surgical technique and early results

Jeon¹,

Hong

Woo

et al. 2019

Journal of Neurosurgery

View full text Add to dashboard Cite

OBJECTIVETumors involving Meckel’s cave remain extremely challenging because of the surrounding complex neurovascular structures and deep-seated location. The authors investigated a new minimal-access technique using the endoscopic transorbital approach (eTOA) through the superior eyelid crease to Meckel’s cave and middle cranial fossa lesions and reviewed the most useful surgical procedures and pitfalls of this approach.METHODSBetween September 2016 and January 2018, the authors performed eTOA in 9 patients with tumors involving Meckel’s cave and the middle cranial fossa. The lesions included trigeminal schwannoma in 4 patients, meningioma in 2 patients, metastatic brain tumor in 1 patient, chondrosarcoma in 1 patient, and dermoid cyst in 1 patient. In 7 of the 9 patients, eTOA alone was performed, while the other 2 patients underwent a combined eTOA and endoscopic endonasal approach or retrosigmoid craniotomy. Data including details of surgical techniques and clinical outcomes were recorded.RESULTSGross-total resection was performed in 7 of the 9 patients (77.8%). Four patients underwent extended eTOA (with lateral orbital rim osteotomy). Drilling of the trapezoid sphenoid floor, a middle fossa “peeling” technique, and full visualization of Meckel’s cave were applied to approach the lesions. Tumors were exposed and removed extradurally in 3 patients and intradurally in 6 patients. There was no postoperative CSF leak.CONCLUSIONSThe eTOA affords a direct route to access Meckel’s cave and middle cranial fossa lesions. With experience, this novel approach can be successfully applied to selected skull base lesions. To achieve successful removal of the tumor, emphasis should be placed on the importance of adequately removing the greater sphenoid wing and vertical crest. However, because of limited working space eTOA may not be an ideal approach for posterior fossa lesions.

show abstract

Endoscopic transorbital and transcranial multiportal resection of a sphenoorbital meningiomas with custom bone 3D printing reconstruction: Case report

d'Avella,

Somma,

Fabozzi

et al. 2023

Head & Neck

View full text Add to dashboard Cite

BackgroundSphenoorbital meningiomas (SOM) harbor intrinsic features that render their surgical management and the reconstruction of the resulting bony defect overtly challenging.MethodsA 70‐year‐old woman, harboring a long‐standing left frontotemporal bony swelling conservatively managed, presented with progressive left proptosis. Radiological features were consistent with an en plaque SOM. A one‐step multiportal transcranial and endoscopic transorbital approach (TOA) with custom bone three‐dimensional (3D) printing reconstruction using polymethylmethacrylate (PMMA) was scheduled.ResultsPostoperative functional and aesthetic results were excellent, with proptosis and calvarian deformity resolution. Tumor subtotal resection was achieved. Histopathological diagnosis confirmed a transitional meningioma (WHO grade I).ConclusionsThe endoscopic TOA, isolated or as part of a multiportal strategy, has entered the surgical armamentarium for the treatment of SOMs. A customized PMMA cranioplasty can be considered a possible option for the reconstruction of large bony defects in a one‐step fashion.

show abstract

Endoscopic Transorbital Superior Eyelid Approach for the Management of Selected Spheno-orbital Meningiomas: Preliminary Experience

Abstract: Our preliminary clinical experience seems to demonstrate that selected spheno-orbital meningiomas can be safely managed by means of an endoscopic transorbital route through a superior eyelid approach. Patients with orbital or cavernous sinus infiltration are at highest risk of persistence.

Cited by 71 publications

References 9 publications

Transorbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and Surgical Technique

Transorbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and Surgical Technique

Endoscopic transorbital surgery for Meckel’s cave and middle cranial fossa tumors: surgical technique and early results

Endoscopic transorbital and transcranial multiportal resection of a sphenoorbital meningiomas with custom bone 3D printing reconstruction: Case report

Contact Info

Product

Resources

About