The use of neuronavigation and intraoperative imaging systems in the surgical treatment of orbital tumors

Abstract

AIM:We aimed to show the effects of neuronavigation and intraoperative imaging systems on the surgical outcomes of orbital tumors. MATERIAL and METHODS:Seventeen patients who underwent surgical treatment for orbital tumors by transcranial and transnasal approaches between 2008 and 2013 were analyzed retrospectively. Twelve of them were male and 5 were female. The mean age was 41.6 years. Neuronavigation systems were used in all cases. Four patients were operated using intraoperative imaging systems. RESULTS:The transcranial approach was used in 9 (53%) patients, endoscopic medial orbital approach in 4 (23.5%), endoscopic inferolateral approach in 1 (6%), cranioorbitozygomatic approach in 1, lateral approach in 1, and the combined (medial endoscopic and lateral) approach in 1 patients. Total resection was achieved in 5 patients, gross total excision in 2, subtotal in 9 and partial in 1 patients. CONCLUSION:Modern technology has made a significant contribution to the treatment of orbital tumors. Although technological equipments facilitate the excision of tumors, the level of resection is mainly determined by the nature of tumor and adhesion to the adjacent neurovascular structures. It should not be forgotten that advanced technology never replaces a good anatomical knowledge and surgical experience, but has a complementary role. BULGULAR: Çalışmada 9 hastaya (%53) transkraniyal yaklaşım, 4 hastaya (%23,5) endoskopik endonazal medial orbital yaklaşım, 1 hastaya (%6) inferolateral endoskopik yaklaşım, 1 hastaya kraniyo-orbitozigomatik yaklaşım, 1 hastaya lateral yaklaşım, 1 hastaya ise kombine (medial endoskopik+lateral) yaklaşım uygulandı. Beş hastada total, 2 hastada gros total, 9 hastada subtotal, 1 hastada ise parsiyel eksizyon yapılabilmiştir. KEywORDS SONUÇ:Modern teknolojinin, orbita tümörlerinin cerrahi tedavisinde cerraha büyük katkıları vardır. Her ne kadar bu teknolojik olanaklar, bu bölge tümörlerinin eksizyonlarını kolaylaştırsa da, yine de tümörün çıkarılma oranını, tümörün natürü ve çevre nörovasküler yapılara olan yapışıklığının derecesi belirlemektedir. İleri teknolojinin hiç bir zaman iyi bir anatomik bilgi ve deneyimin yerini tutamayacağı, ancak bunların tamamlayıcı konumda olabileceği unutulmamalıdır.

Evaluation of Surgical-Navigation System in Management of Orbital Disorders

“…Collectively in our study we completely excised the mass in 70% of cases. However, in a study carried by Hodaj et al, only complete excision could be achieved in five cases (29%) out of seventeen cases although they used orbitotomy approach [8] . In our study, the navigation guidance did enhance the confidence of intraoperative debridement and localization of the extent of lesions through viewing real-time images of axial, coronal and sagittal planes simultaneously.…”

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

“…Optic damages are often caused by direct damage, inappropriate traction, or vascular supply impairment during the dissection. Neuro-navigation is recommended during this approach ( 15 ). In our cohort, 3 of the 4 patients with intraconal lesions presented with preoperative optic neuropathy, without improvement after the surgery.…”

Surgical Techniques and the Choice of Operative Approach for Cranioorbital Lesions

“…In recent years, with the rapid development of orbital disease research, neuroimaging and modern skull base techniques, the diagnosis and treatment of these diseases has been greatly improved. [5][6][7] Through the collaboration of the ophthalmologists and neurosurgeons, 49 cases (51 operations) were performed on cranioorbital lesions in the Department of Neurosurgery of the Third Affiliated Hospital of Sun Yat-Sen University. Herein, the operative routes, operation experiences, and surgical results are summarized.…”