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Clinical applications of the endoscopic transorbital approach for various lesions

 Jihwan Yoo  ;  Hun Ho Park  ;  In-Sik Yun  ;  Chang-Ki Hong 
 ACTA NEUROCHIRURGICA, Vol.163(8) : 2269-2277, 2021-08 
Journal Title
Issue Date
Cerebrospinal Fluid Leak ; Eyelids ; Humans ; Meningeal Neoplasms ; Meningioma / diagnostic imaging ; Meningioma / surgery ; Neuroendoscopy*
Clinical application ; Endoscopic surgery ; Transorbital surgery
Background: The endoscopic transorbital approach (ETOA) was recently added to the neurosurgical armamentarium. Although this approach could result in less injury to normal brain tissue, shorter operation times, and smaller scars, its clinical applications have not been fully investigated. We, therefore, sought to share our unique experiences of exploring the application of this approach in various diseases.

Methods: From June 2017 to March 2019, we conducted ETOAs via the superior eyelid crease in 22 patients for the treatment of lesions confined to the middle fossa with and without slight extension to the posterior fossa. These lesions included 5 gliomas, 11 meningiomas, 3 schwannomas, 1 lymphoma, 1 cavernous hemangioma in the orbital wall, and 1 hemangiopericytoma mimicking schwannoma. Perioperative radiologic findings and clinical outcomes were recorded.

Results: Gross total resection was accomplished in three (60%) patients with gliomas, nine (81.8%) with meningiomas, two (66.7%) with schwannomas, and one (33.3%) with another lesion. The mean bleeding count was 1051.4 ± 961.1 cc, and major complications were observed in only two (9.1%) cases (one major cerebral artery infarction and one reoperation due to a large amount of bleeding). A cerebrospinal fluid leak was reported in two (9.1%) patients, and transient eye movement palsy was noted in four (18.2%) patients without permanent disability.

Conclusions: The endoscopic transorbital approach could be considered to be feasible for various lesions with different characteristics. After carefully considering the lesion anatomy, consistency, and vascular relationships, using this approach, we could achieve a satisfactory extent of resection without severe complications.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Hun Ho(박현호) ORCID logo https://orcid.org/0000-0002-2526-9693
Yoo, Jihwan(유지환)
Yun, In Sik(윤인식) ORCID logo https://orcid.org/0000-0003-1103-7047
Hong, Chang Ki(홍창기) ORCID logo https://orcid.org/0000-0002-2761-0373
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