| OP F-002 |
| Transorbital Endoscopic Surgery for Cranio-orbital Tumours |
| Department of Ophthalmology, National University Hospital, Singapore (1); Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (2);
Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (3) |
| Stephanie Young (1), Kyung In Woo (2), Yoon-Duck Kim (2), Doosik Kong (3) |
|
Purpose : Lesions involving the deep orbit, cavernous sinus, middle fossa, and infratemporal fossa are traditionally challenging to manage. We describe our initial experience using a novel, minimally invasive approach in the management of cranio-orbital tumours involving these areas.
Methods : Interventional case series on surgical management of four patients having cranio-orbital tumours. All patients underwent minimally invasive, neuro-navigated, transorbital, endoscopic-assisted removal of their tumours via an upper lid crease incision. The intracranial portion of the tumours was approached through the deep portion of the lateral orbital wall. Data on the indications for and outcomes of surgery were collected.
Results : Four patients in our centre underwent the combined neurosurgical and orbital procedure: 1) A 64-year-old male had a spheno-cavernous meningioma involving the orbit, causing proptosis and optic neuropathy. Post-surgery, there was decrease in size of the mass with improvement in optic nerve function. 2) A 67-year-old female with an intraorbital schwannoma extending into the cavernous sinus through the superior orbital fissure had severe proptosis and visual loss. Her proptosis improved significantly post-surgery with near-total removal of the mass, although vision remained poor. 3) A 39-year-old female with sphenoid wing meningioma involving the lateral orbit with 8 millimetres of proptosis underwent transorbital removal of the mass with complete resolution of proptosis. 4) A 45-year-old female with recurrent temporal fossa and sphenoid ridge meningioma with severe motility restriction and visual loss underwent endoscopic surgical removal of the tumour with significant debulking of the cranio-orbital mass.
Conclusion : The endoscopic-assisted transorbital approach can be considered as an option in the management of lesions affecting complex anatomical regions as described above, with acceptable sequelae and reduced morbidity in relation to the traditional transcranial approaches. Further studies and larger case series are needed to validate this surgical technique and to assess its equivalency with craniotomy based approaches.
|
| |