BACKGROUND/AIMS: Transorbital approaches traditionally have focused on skull base and cavernous sinus lesions medial to the globe. Lateral orbital approaches to the temporal lobe have not been widely explored despite several theoretical advantages compared to open craniotomy. Recently, we demonstrated the feasibility of the lateral transorbital technique in cadaveric specimens with endoscopic visualization. We describe our initial clinical experience with the endoscope-assisted lateral transorbital approach to lesions in the temporal lobe. METHODS: Two patients with mesial temporal lobe pathology presenting with seizures underwent surgery. The use of a transpalpebral or Stallard-Wright eyebrow incision enabled access to the intraorbital compartment, and a lateral orbital wall 'keyhole' opening permitted visualization of the anterior temporal pole. RESULTS: This approach afforded adequate access to the surgical target and surrounding structures and was well tolerated by the patients. To the best of our knowledge, this report constitutes the first case series describing the endoscope-assisted lateral transorbital approach to the temporal lobe. We discuss the limits of exposure, the nuances of opening and closing, and comparisons to open craniotomy. CONCLUSION: Further prospective investigation of this approach is warranted for comparison to traditional approaches to the mesial temporal lobe.
BACKGROUND/AIMS: Transorbital approaches traditionally have focused on skull base and cavernous sinus lesions medial to the globe. Lateral orbital approaches to the temporal lobe have not been widely explored despite several theoretical advantages compared to open craniotomy. Recently, we demonstrated the feasibility of the lateral transorbital technique in cadaveric specimens with endoscopic visualization. We describe our initial clinical experience with the endoscope-assisted lateral transorbital approach to lesions in the temporal lobe. METHODS: Two patients with mesial temporal lobe pathology presenting with seizures underwent surgery. The use of a transpalpebral or Stallard-Wright eyebrow incision enabled access to the intraorbital compartment, and a lateral orbital wall 'keyhole' opening permitted visualization of the anterior temporal pole. RESULTS: This approach afforded adequate access to the surgical target and surrounding structures and was well tolerated by the patients. To the best of our knowledge, this report constitutes the first case series describing the endoscope-assisted lateral transorbital approach to the temporal lobe. We discuss the limits of exposure, the nuances of opening and closing, and comparisons to open craniotomy. CONCLUSION: Further prospective investigation of this approach is warranted for comparison to traditional approaches to the mesial temporal lobe.
Authors: Davide Locatelli; Francesco Restelli; Tommaso Alfiero; Alberto Campione; Fabio Pozzi; Sergio Balbi; Alberto Arosio; Paolo Castelnuovo Journal: J Neurol Surg B Skull Base Date: 2020-12-22
Authors: Sergio Garcia-Garcia; Sofia Kakaizada; Laura Oleaga; Arnau Benet; Jordina Rincon-Toroella; José Juan González-Sánchez Journal: Neurol India Date: 2019 May-Jun Impact factor: 2.117
Authors: Alperen Vural; Andrea Luigi Camillo Carobbio; Marco Ferrari; Vittorio Rampinelli; Alberto Schreiber; Davide Mattavelli; Francesco Doglietto; Barbara Buffoli; Luigi Fabrizio Rodella; Stefano Taboni; Michele Tomasoni; Tommaso Gualtieri; Alberto Deganello; Lena Hirtler; Piero Nicolai Journal: Neurosurg Rev Date: 2021-01-22 Impact factor: 3.042