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

Dallan, Iacopo; Castelnuovo, Paolo; Locatelli, Davide; Turri‐Zanoni, Mario; Alqahtani, Abdulaziz; Battaglia, Paolo; Hirt, Bernard; Sellari–Franceschini, Stefano

doi:10.1016/j.wneu.2015.02.034

Cited by 95 publications

(102 citation statements)

References 23 publications

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“…Trigeminal schwannomas (TSs) are the most common skull‐base schwannomas after vestibular schwannomas and account for up to 0.36% of all intracranial neoplasms and 8% of skull‐base schwannomas . Most of them develop in the Gasserian ganglion, but they can occur anywhere along the course of the trigeminal root, ganglion, and peripheral branches.…”

Section: Benign Lesionsmentioning

confidence: 99%

“…Most of them develop in the Gasserian ganglion, but they can occur anywhere along the course of the trigeminal root, ganglion, and peripheral branches. Therefore, they can be intradural, interdural, and extradural, can exist in the posterior fossa and middle fossa/Meckel's cave, and extend along V1 into the orbit, V2 into the pterygopalatine fossa (PPF), and V3 into the infratemporal fossa …”

Section: Benign Lesionsmentioning

confidence: 99%

“…They are usually separable from neighboring neurovascular structures, because CNs and ICA are typically displaced rather than engulfed. They do not intrude into the cavernous sinus and subdural space …”

Section: Benign Lesionsmentioning

confidence: 99%

“…In larger reported series, either permanent or transient postoperative deterioration in neurological function, including trigeminal neuropathy, abducens nerve palsy, and trigeminal neuralgia, was experienced. When microsurgery alone is applied, up to 85% of cases can be safely resected, with minor complications reported . The most challenging type is the dumbbell‐shaped tumor that crosses the petrous apex to occupy the posterior and middle cranial fossa or has both intracranial and extracranial extension …”

Section: Benign Lesionsmentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

143

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Section: Benign Lesionsmentioning

confidence: 99%

Section: Benign Lesionsmentioning

confidence: 99%

Section: Benign Lesionsmentioning

confidence: 99%

Section: Benign Lesionsmentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

143

279

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“…5 Blind removal of foreign bodies has been reported, 6 however the development of combined-multiportal endoscopic approaches enabled surgeons to reach different regions through minimally invasive routes with lower incidence of complications, lower morbidity, and mortality rates compared with traditional external approaches. 4,[7][8][9] Reconstruction of anterior skull base defects remains the most challenging issue in this field with postoperative cerebrospinal fluid leak, 9 however, the introduction of different vascularized nasoseptal flaps dramatically decreased the rates of postoperative cerebrospinal fluid leak and improved the quality of life of patients, reducing postoperative nasal crusting and hospitalization time rates ranging from 3.3% to 4.3%. [10][11][12] …”

Section: Discussionmentioning

confidence: 99%

Combined External-Endoscopic Endonasal Assisted Removal of a Nail Gun

Dehgani-Mobaraki

Longari²,

Lapenna³

et al. 2016

Journal of Craniofacial Surgery

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Management of penetrating trauma to the paranasal sinuses with retained foreign bodies represents a challenge due to the proximity to vital neurovascular structures. The authors report the successful treatment of a patient with a work-related nail gun injury, carried out by means of a combined endoscopic endonasal external assisted procedure.A transnasal endoscopic approach was planned to minimize inadvertent movements of the nail during surgery and in case necessary to repair the orbit or skull base. No major bleeding or neurovascular complication was observed after surgery and a computed tomography scan was performed after surgery confirming the complete removal of the nail and with no damage of the orbit nor the skull base.

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Orbital resection by intranasal technique (ORBIT): A new classification system for reporting endoscopically resectable primary benign orbital tumors

Jafari

Adappa

Anagnos

et al. 2023

Int Forum Allergy Rhinol

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BackgroundThe Cavernous Hemangioma Exclusively Endonasal Resection (CHEER) staging system has become the gold standard for outcomes reporting in endoscopic orbital surgery for orbital cavernous hemangiomas (OCHs). A recent systematic review demonstrated similar outcomes between OCHs and other primary benign orbital tumors (PBOTs). Therefore, we hypothesized that a simplified and more comprehensive classification system could be developed to predict surgical outcomes of other PBOTs.MethodsPatient and tumor characteristics as well as surgical outcomes from 11 international centers were recorded. All tumors were retrospectively assigned an Orbital Resection by Intranasal Technique (ORBIT) class and stratified based on surgical approach as either exclusively endoscopic or combined (endoscopic and open). Outcomes based on approach were compared using chi‐squared or Fisher's exact tests. The Cochrane‐Armitage test for trend was used to analyze outcomes by class.ResultsFindings from 110 PBOTs from 110 patients (age 49.0 ± 15.0 years, 51.9% female) were included in the analysis. Higher ORBIT class was associated with a lower likelihood of gross total resection (GTR). GTR was more likely to be achieved when an exclusively endoscopic approach was utilized (p < 0.05). Tumors resected using a combined approach tended to be larger, to present with diplopia, and to have an immediate postoperative cranial nerve palsy (p < 0.05).ConclusionEndoscopic treatment of PBOTs is an effective approach, with favorable short‐term and long‐term postoperative outcomes as well as low rate of adverse events. The ORBIT classification system is an anatomic‐based framework that effectively facilitates high‐quality outcomes reporting for all PBOTs.

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

Cited by 95 publications

References 23 publications

ICAR: endoscopic skull‐base surgery

ICAR: endoscopic skull‐base surgery

Combined External-Endoscopic Endonasal Assisted Removal of a Nail Gun

Orbital resection by intranasal technique (ORBIT): A new classification system for reporting endoscopically resectable primary benign orbital tumors

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