Minimally Invasive 360-Degree Approach to Intraconal Orbital Tumors

Caballero-García, Joel; Aparicio-García, Carlos; Linares-Benavides, Yurledys Jhohana; López-Sánchez, Misael; Abreu-Perdomo, Franklyn Alain; Huanca-Amaru, Juvenal

doi:10.1016/j.ajo.2020.07.035

Cited by 11 publications

(5 citation statements)

References 29 publications

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“…In addition, the ON and medial rectus muscle (MR) are the critical structural and anatomic landmarks when decompressing near the AZ of the orbital apex during endoscopic surgery. 16 It is vital for accessing the medial space in endoscopic surgery to study the relationship between the ON and MR in the area of the AZ.…”

mentioning

confidence: 99%

Formation and Fixation of the Annulus of Zinn and Relation With Extraocular Muscles: A Plastinated Histologic Study and Its Clinical Significance

Zhu

Chu

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Purpose This study aimed to clarify the formation and fixation of the annulus of Zinn (AZ) and its relationship with the extraocular muscles by using ultrathin plastination and three-dimensional models. Methods Eighteen cadaveric heads (36 sides of the orbital apex) were plastinated to coronal (16 sides), sagittal (13 sides), and horizontal (5 sides) ultrathin plastination sections to be investigated at both macroscopic and microscopic levels. One cadaveric head was used for endoscopic dissection to identify anatomic landmarks. Results There were two fibrous triangles adhered to both ends of the anterior surface of the optic strut. The superior rectus muscle originated from the superior fibrous triangle, and the lateral, inferior, and medial rectus muscles emerged from the inferior fibrous triangle. It was not until 5.46 ± 0.41 mm anterior to the optic strut that the complete tendinous ring composed of rectus muscles, optic nerve sheath, and periosteum was formed. The superior oblique and levator palpebrae superioris muscles originated from the medial fibrous band of the AZ. At the posterior of the AZ, there was a potential passage between the medial rectus muscle and the optic nerve. Conclusions The fixation of the AZ was composed of the connection of the annular tendon to the optic strut posteriorly and the attachment of the complete tendinous ring to the lesser and greater wings of the sphenoid bone anteriorly. The triangular route area between the optic nerve and medial rectus muscle was located on the anterior side of the base of the optic strut.

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confidence: 99%

Formation and Fixation of the Annulus of Zinn and Relation With Extraocular Muscles: A Plastinated Histologic Study and Its Clinical Significance

Zhu

Chu

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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“…Some surgeons summarized a 360° “round-the-clock” surgical access to the orbit ( 9 , 13 ), and they suggested the endoscopic endonasal approach for lesions at the mid or posterior orbit or orbital apex from 1 to 7 o’clock. In our case series, four of the six tumors occupied the lateral quadrants to the optic nerve, three of which were intraconal tumors.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Endonasal Intraconal Approach for Orbital Tumor Resection: Case Series and Systematic Review

et al. 2022

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Intraorbital tumor could be approached by numerous surgical methods. The neuroendoscopic endonasal approach could provide a feasible corridor for indicated tumors. Herein we present a series of 6 consecutive intraorbital tumors from April 2018 to October 2020, which received endonasal endoscopic resection. Cadaveric dissection was performed for the intraconal approach, and the literature was also reviewed. Five tumors were located intraconally, while one extraconally. The pathology revealed 1 angioleiomyoma, 1 cavernous hemangioma, 1 pilocytic astrocytoma, 1 meningioma, and 2 schwannomas. Five of the six achieved gross total resection, including 3 tumors with lateral extension beyond the optic nerve. Preoperative visual deterioration was observed in 4 of the 6 patients, and all got improvement postoperatively. Transient oculomotor nerve palsy was presented in one patient postoperatively. No cerebrospinal fluid leakage, enophthalmos, or strabismus was observed. The median follow-up time is 27 months (11~41 months). At the 6-month follow-up, the visual acuity remained unchanged compared with that at discharge. Proptosis was resolved in 2 of the 3 patients; diplopia was improved in one patient. In conclusion, endoscopic endonasal intraconal approach could be suitable for selected pathological conditions, and for both medial or beyond medial extraconal and intraconal orbital tumors.

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“…Several cases of endoscopic endonasal optic canal decompression and GTR were recently published with encouraging outcomes. However, the value of endoscopic surgery for these lesions remains unclear 921–924 …”

Section: Benign Orbital Tumors and Lesionsmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

Kuan

Wang

Adappa

et al. 2024

Int Forum Allergy Rhinol

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BackgroundSinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represents a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology‐based topics spanning the field.MethodsIn accordance with prior ICAR documents, ICSNT assigned each topic as an Evidence‐Based Review with Recommendations, Evidence‐Based Review, and Literature Review based on level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses format, and completed sections underwent a thorough and iterative consensus‐building process. The final document underwent rigorous synthesis and review prior to publication.ResultsThe ICNST document consists of 4 major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology‐based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention.ConclusionAs an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses.This article is protected by copyright. All rights reserved

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Minimally Invasive 360-Degree Approach to Intraconal Orbital Tumors

Cited by 11 publications

References 29 publications

Formation and Fixation of the Annulus of Zinn and Relation With Extraocular Muscles: A Plastinated Histologic Study and Its Clinical Significance

Formation and Fixation of the Annulus of Zinn and Relation With Extraocular Muscles: A Plastinated Histologic Study and Its Clinical Significance

Endoscopic Endonasal Intraconal Approach for Orbital Tumor Resection: Case Series and Systematic Review

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

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