Mohamed M Arnaout1, Sabino Luzzi2, Renato Galzio3, Khaled Aziz4. 1. Department of Neurosurgery, Zagazig University, Sharkia, Egypt; Deparment of Neurosurgery, Allegheny General Hospital, Drexel University College of Medicine, Pittsburgh, PA, United States. Electronic address: Mohamedarnaout@yahoo.com. 2. Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy. Electronic address: sabino.luzzi@gmail.com. 3. Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy. Electronic address: r.galzio@smatteo.pv.it. 4. Deparment of Neurosurgery, Allegheny General Hospital, Drexel University College of Medicine, Pittsburgh, PA, United States. Electronic address: kaziz@wpahs.org.
Abstract
OBJECTIVE: To assess the assumed advantages of pure endoscopic and endoscope-assisted methods for the supraorbital keyhole approach. The aim is to demonstrate visibility and accessibility of the pure endoscope approach as a possible standard approach for the supraorbital keyhole approach. PATIENTS AND METHODS: We performed eight dissections on four cadaver heads using an operating microscope, an endoscope, and neuronavigation. The visibility and accessibility of the anterior and middle cranial fossae regions were compared for each. Special structures were defined to assess their preservation in both approaches. We used pure endoscopy on the eight sides and with a microscope on those same eight sides. Accessibility was quantified for key structures using linear measurements taken with the navigation system. In addition, we present clinical cases in which an endoscope-assisted supraorbital approach was employed. RESULTS: Our measurements have been reported for each side in the formalin-fixed heads as the mean ± SD (in mm) from the bone margin to selected regions. Moreover, image analysis was performed using ImageJ software to compare selected surface area measurements between the endoscope and microscope images on each side for all cadaveric available specimens. There were no significant statistical differences between visualization of the selected areas. This means that by visual analysis both endoscopic and microscopic images can provide the surgeon nearly the same visibility and accessibility of a selected region. CONCLUSION: A pure endoscopic method can be used to conduct the supraorbital keyhole approach when the endoscope is used as a primary tool. Our recommendation is to use the measurements described in this study for preoperative planning of the keyhole approach. We believe that with advances in neuro-endoscope technology, and instrumentations, the endoscopic approach may replace the microscopic approach in the near future.
OBJECTIVE: To assess the assumed advantages of pure endoscopic and endoscope-assisted methods for the supraorbital keyhole approach. The aim is to demonstrate visibility and accessibility of the pure endoscope approach as a possible standard approach for the supraorbital keyhole approach. PATIENTS AND METHODS: We performed eight dissections on four cadaver heads using an operating microscope, an endoscope, and neuronavigation. The visibility and accessibility of the anterior and middle cranial fossae regions were compared for each. Special structures were defined to assess their preservation in both approaches. We used pure endoscopy on the eight sides and with a microscope on those same eight sides. Accessibility was quantified for key structures using linear measurements taken with the navigation system. In addition, we present clinical cases in which an endoscope-assisted supraorbital approach was employed. RESULTS: Our measurements have been reported for each side in the formalin-fixed heads as the mean ± SD (in mm) from the bone margin to selected regions. Moreover, image analysis was performed using ImageJ software to compare selected surface area measurements between the endoscope and microscope images on each side for all cadaveric available specimens. There were no significant statistical differences between visualization of the selected areas. This means that by visual analysis both endoscopic and microscopic images can provide the surgeon nearly the same visibility and accessibility of a selected region. CONCLUSION: A pure endoscopic method can be used to conduct the supraorbital keyhole approach when the endoscope is used as a primary tool. Our recommendation is to use the measurements described in this study for preoperative planning of the keyhole approach. We believe that with advances in neuro-endoscope technology, and instrumentations, the endoscopic approach may replace the microscopic approach in the near future.
Authors: Alice Giotta Lucifero; Juan C Fernandez-Miranda; Maximiliano Nunez; Nunzio Bruno; Nicola Tartaglia; Antonio Ambrosi; Gian Luigi Marseglia; Renato Galzio; Sabino Luzzi Journal: Acta Biomed Date: 2021-08-26
Authors: Gabriele Savioli; Iride Francesca Ceresa; Sarah Macedonio; Sebastiano Gerosa; Mirko Belliato; Giorgio Antonio Iotti; Sabino Luzzi; Mattia Del Maestro; Gianluca Mezzini; Alice Giotta Lucifero; Elvis Lafe; Anna Simoncelli; Federica Manzoni; Lorenzo Cobianchi; Mario Mosconi; Fabrizio Cuzzocrea; Francesco Benazzo; Giovanni Ricevuti; Maria Antonietta Bressan Journal: Medicina (Kaunas) Date: 2020-04-24 Impact factor: 2.430