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07.06.2019 | Original Article - Tumor - Meningioma

Endoscopic endo- and extra-orbital corridors for spheno-orbital region: anatomic study with illustrative case

verfasst von: Andrea De Rosa, Jose Pineda, Luigi Maria Cavallo, Alberto Di Somma, Antonio Romano, Thomaz E. Topczewski, Teresa Somma, Domenico Solari, Joaquim Enseñat, Paolo Cappabianca, Alberto Prats-Galino

Erschienen in: Acta Neurochirurgica | Ausgabe 8/2019

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Abstract

Background and objective

Management of selected spheno-orbital meningiomas via the endoscopic transorbital route has been reported. Surgical maneuverability in a narrow corridor as that offered by the orbit may be challenging. We investigate the additional use of an extra-orbital (EXO) path to be used in combination with the endo-orbital (EO) corridor.

Material and methods

Three human cadaveric heads (six orbits) were dissected at the Laboratory of Surgical Neuroanatomy at the University of Barcelona. The superior eyelid endoscopic transorbital approach was adopted, introducing surgical instruments via both corridors. Surgical freedom analysis was run to determine directionality of each corridor and to calculate the surgical maneuverability related to three anatomic targets: superior orbital fissure (SOF), foramen rotundum (FR), and foramen ovale (FO). We also reported of a 37-year-old woman with a spheno-orbital meningioma with hyperostosis of the lateral wall of the right orbit, treated with such combined endo-orbital and extra-orbital endoscopic approach.

Results

Combining both endo-orbital and extra-orbital corridors permitted a greater surgical freedom for all the targets compared with the surgical freedom of each corridor alone (EO + EXO to SOF: 3603.8 mm² ± 2452.5 mm²; EO + EXO to FR: 1533.0 mm² ± 892.2 mm²; EO + EXO to FO: 1193.9 mm² ± 782.6 mm²). Analyzing the extra-orbital pathway, our results showed that the greatest surgical freedom was gained in the most medial portion of the considered area, namely the SOF (1180.5 mm² ± 648.3 mm²). Regarding the surgical case, using both pathways, we gained enough maneuverability to nearly achieve total resection with no postoperative complications.

Conclusion

An extra-orbital corridor may be useful to increase the instruments’ maneuverability, during a pure endoscopic superior eyelid approach, and to reach the most medial portion of the surgical field from a lateral-to-medial trajectory. Further studies are needed to better define the proper indications for such strategy.

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Abdel Aziz KM, Bhatia S, Tantawy MH, Sekula R, Keller JT, Froelich S, Happ E (2011) Minimally invasive transpalpebral “eyelid” approach to the anterior cranial base. Neurosurgery 69:ons195–ons206; discussion 206-197. https://doi.org/10.1227/NEU.0b013e31821c3ea3 CrossRefPubMed

Al-Mefty O (1987) Supraorbital-pterional approach to skull base lesions. Neurosurgery 21:474–477CrossRefPubMed

Almeida JP, Omay SB, Shetty SR, Chen YN, Ruiz-Treviño AS, Liang B, Anand VK, Levine B, Schwartz TH (2017) Transorbital endoscopic eyelid approach for resection of sphenoorbital meningiomas with predominant hyperostosis: report of 2 cases. J Neurosurg:1–11. https://doi.org/10.3171/2017.3.JNS163110

Almeida JP, Ruiz-Treviño AS, Shetty SR, Omay SB, Anand VK, Schwartz TH (2017) Transorbital endoscopic approach for exposure of the sylvian fissure, middle cerebral artery and crural cistern: an anatomical study. Acta Neurochir 159:1893–1907. https://doi.org/10.1007/s00701-017-3296-8 CrossRefPubMed

Altay T, Patel BC, Couldwell WT (2012) Lateral orbital wall approach to the cavernous sinus. J Neurosurg 116:755–763. https://doi.org/10.3171/2011.12.JNS111251 CrossRefPubMed

Amirjamshidi A, Abbasioun K, Amiri RS, Ardalan A, Hashemi SM (2015) Lateral orbitotomy approach for removing hyperostosing en plaque sphenoid wing meningiomas. Description of surgical strategy and analysis of findings in a series of 88 patients with long-term follow up. Surg Neurol Int 6:79. https://doi.org/10.4103/2152-7806.157074 CrossRefPubMedPubMedCentral

Berhouma M, Jacquesson T, Jouanneau E (2011) The fully endoscopic supraorbital trans-eyebrow keyhole approach to the anterior and middle skull base. Acta Neurochir 153:1949–1954. https://doi.org/10.1007/s00701-011-1089-z CrossRefPubMed

Bly RA, Ramakrishna R, Ferreira M, Moe KS (2014) Lateral transorbital neuroendoscopic approach to the lateral cavernous sinus. J Neurol Surg B Skull Base 75:11–17. https://doi.org/10.1055/s-0033-1353363 CrossRefPubMed

Cannon PS, Rutherford SA, Richardson PL, King A, Leatherbarrow B (2009) The surgical management and outcomes for spheno-orbital meningiomas: a 7-year review of multi-disciplinary practice. Orbit 28:371–376. https://doi.org/10.3109/01676830903104645 CrossRefPubMed

10.

Chen HI, Bohman LE, Emery L, Martinez-Lage M, Richardson AG, Davis KA, Pollard JR, Litt B, Gausas RE, Lucas TH (2015) Lateral transorbital endoscopic access to the hippocampus, amygdala, and entorhinal cortex: initial clinical experience. ORL J Otorhinolaryngol Relat Spec 77:321–332. https://doi.org/10.1159/000438762 CrossRefPubMed

11.

Ciporen J, Lucke-Wold B, Dogan A, Cetas JS, Cameron WE (2016) Dual endoscopic endonasal transsphenoidal and precaruncular transorbital approaches for clipping of the cavernous carotid artery: a cadaveric simulation. J Neurol Surg B Skull Base 77:485–490. https://doi.org/10.1055/s-0036-1584094 CrossRefPubMedPubMedCentral

12.

Ciporen JN, Moe KS, Ramanathan D, Lopez S, Ledesma E, Rostomily R, Sekhar LN (2010) Multiportal endoscopic approaches to the central skull base: a cadaveric study. World Neurosurg 73:705–712. https://doi.org/10.1016/j.wneu.2010.03.033 CrossRefPubMed

13.

Dallan I, Castelnuovo P, Locatelli D, Turri-Zanoni M, AlQahtani A, Battaglia P, Hirt B, Sellari-Franceschini S (2015) Multiportal combined transorbital transnasal endoscopic approach for the management of selected skull base lesions: preliminary experience. World Neurosurg 84:97–107. https://doi.org/10.1016/j.wneu.2015.02.034 CrossRefPubMed

14.

Dallan I, Castelnuovo P, Turri-Zanoni M, Fiacchini G, Locatelli D, Battaglia P, Sellari-Franceschini S (2016) Transorbital endoscopic assisted management of intraorbital lesions: lessons learned from our first 9 cases. Rhinology 54:247–253. https://doi.org/10.4193/Rhin15.237 CrossRefPubMed

15.

Dallan I, Di Somma A, Prats-Galino A, Solari D, Alobid I, Turri-Zanoni M, Fiacchini G, Castelnuovo P, Catapano G, de Notaris M (2017) Endoscopic transorbital route to the cavernous sinus through the meningo-orbital band: a descriptive anatomical study. J Neurosurg 127:622–629. https://doi.org/10.3171/2016.8.JNS16465 CrossRefPubMed

16.

Dallan I, Sellari-Franceschini S, Turri-Zanoni M, de Notaris M, Fiacchini G, Fiorini FR, Battaglia P, Locatelli D, Castelnuovo P (2018) Endoscopic transorbital superior eyelid approach for the management of selected spheno-orbital meningiomas: preliminary experience. Oper Neurosurg (Hagerstown) 14:243–251. https://doi.org/10.1093/ons/opx100 CrossRef

17.

de Notaris M, Prats-Galino A (2014) Surgical freedom: a challenging topic in endoscopic endonasal approaches. World Neurosurg 82:e387–e388. https://doi.org/10.1016/j.wneu.2012.10.071 CrossRefPubMed

18.

de Notaris M, Prats-Galino A, Enseñat J, Topczewski T, Ferrer E, Cavallo LM, Cappabianca P, Solari D (2014) Quantitative analysis of progressive removal of nasal structures during endoscopic suprasellar approach. Laryngoscope 124:2231–2237. doi:https://doi.org/10.1002/lary.24693

19.

Di Somma A, Andaluz N, Cavallo LM, de Notaris M, Dallan I, Solari D, Zimmer LA, Keller JT, Zuccarello M, Prats-Galino A, Cappabianca P (2017) Endoscopic transorbital superior eyelid approach: anatomical study from a neurosurgical perspective. J Neurosurg:1–14. https://doi.org/10.3171/2017.4.JNS162749

20.

Di Somma A, Andaluz N, Cavallo LM, Enseñat J, Prats-Galino A, Cappabianca P (2018) Reply to letter: Endoscopic transpalpebral transorbital anterior petrosectomy: does safer surgical freedoms necessitates modifications? Acta Neurochir. https://doi.org/10.1007/s00701-018-3594-9

21.

Di Somma A, Andaluz N, Cavallo LM, Topczewski TE, Frio F, Gerardi RM, Pineda J, Solari D, Enseñat J, Prats-Galino A, Cappabianca P (2018) Endoscopic transorbital route to the petrous apex: a feasibility anatomic study. Acta Neurochir 160:707–720. https://doi.org/10.1007/s00701-017-3448-x CrossRefPubMed

22.

Di Somma A, Andaluz N, Gogela S, Cavallo LM, Keller JT, Prats-Galino A, Cappabianca P (2017) Surgical freedom evaluation during optic nerve decompression. Laboratory Investigation World Neurosurg. https://doi.org/10.1016/j.wneu.2017.01.117

23.

Di Somma A, Cavallo LM, de Notaris M, Solari D, Topczewski TE, Bernal-Sprekelsen M, Enseñat J, Prats-Galino A, Cappabianca P (2017) Endoscopic endonasal medial-to-lateral and transorbital lateral-to-medial optic nerve decompression: an anatomical study with surgical implications. J Neurosurg 127:199–208. https://doi.org/10.3171/2016.8.JNS16566 CrossRefPubMed

24.

Freeman JL, Davern MS, Oushy S, Sillau S, Ormond DR, Youssef AS, Lillehei KO (2017) Spheno-orbital meningiomas: a 16-year surgical experience. World Neurosurg 99:369–380. https://doi.org/10.1016/j.wneu.2016.12.063 CrossRefPubMed

25.

Honig S, Trantakis C, Frerich B, Sterker I, Kortmann RD, Meixensberger J (2010) Meningiomas involving the sphenoid wing outcome after microsurgical treatment—a clinical review of 73 cases. Cent Eur Neurosurg 71:189–198. https://doi.org/10.1055/s-0030-1261945 CrossRefPubMed

26.

Honig S, Trantakis C, Frerich B, Sterker I, Schober R, Meixensberger J (2010) Spheno-orbital meningiomas: outcome after microsurgical treatment: a clinical review of 30 cases. Neurol Res 32:314–325. https://doi.org/10.1179/016164109X12464612122614 CrossRefPubMed

27.

Kenyon B, Antisdel JL (2014) Anatomic evaluation of endoscopic transnasal transorbital approach to the lateral orbital apex. Am J Rhinol Allergy 28:82–85. https://doi.org/10.2500/ajra.2014.28.4000 CrossRefPubMed

28.

Kong DS, Young SM, Hong CK, Kim YD, Hong SD, Choi JW, Seol HJ, Lee JI, Shin HJ, Nam DH, Woo KI (2018) Clinical and ophthalmological outcome of endoscopic transorbital surgery for cranioorbital tumors. J Neurosurg:1–9. https://doi.org/10.3171/2018.3.JNS173233

29.

Lee MH, Hong SD, Woo KI, Kim YD, Choi JW, Seol HJ, Lee JI, Shin HJ, Nam DH, Kong DS (2018) Endoscopic endonasal vs. transorbital surgery for middle cranial fossa tumors: comparison of clinical outcomes based on surgical corridors. World Neurosurg. https://doi.org/10.1016/j.wneu.2018.11.090

30.

Lew H, Rootman DB, Nassiri N, Goh A, Goldberg RA (2014) Transorbital approach without craniotomy to orbital tumors with extradural intracranial extension. Orbit 33:343–351. https://doi.org/10.3109/01676830.2014.904374 CrossRefPubMed

31.

Mariniello G, Maiuri F, de Divitiis E, Bonavolontà G, Tranfa F, Iuliano A, Strianese D (2010) Lateral orbitotomy for removal of sphenoid wing meningiomas invading the orbit. Neurosurgery 66:287–292; discussion 292. https://doi.org/10.1227/01.NEU.0000369924.87437.0B CrossRefPubMed

32.

Mavar-Haramija M, Prats-Galino A, Méndez JA, Puigdelívoll-Sánchez A, de Notaris M (2015) Interactive 3D-PDF presentations for the simulation and quantification of extended endoscopic endonasal surgical approaches. J Med Syst 39:127. https://doi.org/10.1007/s10916-015-0282-7 CrossRefPubMed

33.

McDermott MW, Durity FA, Rootman J, Woodhurst WB (1990) Combined frontotemporal-orbitozygomatic approach for tumors of the sphenoid wing and orbit. Neurosurgery 26:107–116CrossRefPubMed

34.

Moe KS, Bergeron CM, Ellenbogen RG (2010) Transorbital neuroendoscopic surgery. Neurosurgery 67:ons16–ons28. https://doi.org/10.1227/01.NEU.0000373431.08464.43 CrossRefPubMed

35.

Mortazavi MM, Brito da Silva H, Ferreira M, Barber JK, Pridgeon JS, Sekhar LN (2016) Planum sphenoidale and tuberculum sellae meningiomas: operative nuances of a modern surgical technique with outcome and proposal of a new classification system. World Neurosurg 86:270–286. https://doi.org/10.1016/j.wneu.2015.09.043 CrossRefPubMed

36.

Noiphithak R, Yanez-Siller JC, Revuelta Barbero JM, Otto BA, Carrau RL, Prevedello DM (2018) Comparative analysis between lateral orbital rim preservation and osteotomy for transorbital endoscopic approaches to the cavernous sinus: an anatomic study. Oper Neurosurg (Hagerstown). https://doi.org/10.1093/ons/opy054

37.

Noiphithak R, Yanez-Siller JC, Revuelta Barbero JM, Otto BA, Carrau RL, Prevedello DM (2018) Quantitative analysis of the surgical exposure and surgical freedom between transcranial and transorbital endoscopic anterior petrosectomies to the posterior fossa. J Neurosurg:1–9. https://doi.org/10.3171/2018.2.JNS172334

38.

Peron S, Cividini A, Santi L, Galante N, Castelnuovo P, Locatelli D (2017) Spheno-orbital meningiomas: when the endoscopic approach is better. Acta Neurochir Suppl 124:123–128. https://doi.org/10.1007/978-3-319-39546-3_19 CrossRefPubMed

39.

Ramakrishna R, Kim LJ, Bly RA, Moe K, Ferreira M (2016) Transorbital neuroendoscopic surgery for the treatment of skull base lesions. J Clin Neurosci 24:99–104. https://doi.org/10.1016/j.jocn.2015.07.021 CrossRefPubMed

40.

Reisch R, Perneczky A (2005) Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision. Neurosurgery 57:242–255; discussion 242-255PubMed

41.

Reisch R, Perneczky A, Filippi R (2003) Surgical technique of the supraorbital key-hole craniotomy. Surg Neurol 59:223–227CrossRefPubMed

42.

Sandalcioglu IE, Gasser T, Mohr C, Stolke D, Wiedemayer H (2005) Spheno-orbital meningiomas: interdisciplinary surgical approach, resectability and long-term results. J Craniomaxillofac Surg 33:260–266. https://doi.org/10.1016/j.jcms.2005.01.013 CrossRefPubMed

43.

Schick U, Bleyen J, Bani A, Hassler W (2006) Management of meningiomas en plaque of the sphenoid wing. J Neurosurg 104:208–214. https://doi.org/10.3171/jns.2006.104.2.208 CrossRefPubMed

44.

Schmidt BL, Pogrel MA, Hakim-Faal Z (2001) The course of the temporal branch of the facial nerve in the periorbital region. J Oral Maxillofac Surg 59:178–184. https://doi.org/10.1053/joms.2001.18271 CrossRefPubMed

45.

Shin M, Kondo K, Saito N (2015) Current status of endoscopic endonasal surgery for skull base meningiomas: review of the literature. Neurol Med Chir (Tokyo) 55:735–743. https://doi.org/10.2176/nmc.ra.2015-0031 CrossRef

46.

Shrivastava RK, Sen C, Costantino PD, Della Rocca R (2005) Sphenoorbital meningiomas: surgical limitations and lessons learned in their long-term management. J Neurosurg 103:491–497. https://doi.org/10.3171/jns.2005.103.3.0491 CrossRefPubMed

47.

Tham T, Costantino P, Bruni M, Langer D, Boockvar J, Singh P (2015) Multiportal combined transorbital and transnasal endoscopic resection of fibrous dysplasia. J Neurol Surg Rep 76:e291–e296. https://doi.org/10.1055/s-0035-1566126 CrossRefPubMedPubMedCentral

48.

Turel MK, Tsermoulas G, Reddy D, Andrade-Barazarte H, Zadeh G, Gentili F (2016) Endonasal endoscopic transsphenoidal excision of tuberculum sellae meningiomas: a systematic review. J Neurosurg Sci 60:463–475PubMed

49.

van Lindert E, Perneczky A, Fries G, Pierangeli E (1998) The supraorbital keyhole approach to supratentorial aneurysms: concept and technique. Surg Neurol 49:481–489; discussion 489-490 CrossRefPubMed

50.

Zoia C, Bongetta D, Gaetani P (2018) Endoscopic transorbital surgery for spheno-orbital lesions: how I do it. Acta Neurochir. https://doi.org/10.1007/s00701-018-3529-5

Titel: Endoscopic endo- and extra-orbital corridors for spheno-orbital region: anatomic study with illustrative case
verfasst von: Andrea De Rosa
Jose Pineda
Luigi Maria Cavallo
Alberto Di Somma
Antonio Romano
Thomaz E. Topczewski
Teresa Somma
Domenico Solari
Joaquim Enseñat
Paolo Cappabianca
Alberto Prats-Galino
Publikationsdatum: 07.06.2019
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 8/2019
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-019-03939-9

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Endoscopic endo- and extra-orbital corridors for spheno-orbital region: anatomic study with illustrative case

Abstract

Background and objective

Material and methods

Results

Conclusion

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Abstract

Background and objective

Material and methods

Results

Conclusion

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