Effect of orbitotomy on surgical freedom in Endoscopic Transorbital Approach (ETOA) to the skull base: An anatomical study
Introduction: To investigate the angle of attacks and surgical freedom in different extents of orbitotomy for Endoscopic Transorbital Approach to the skull base. Background: Endoscopic Transorbital Approach is gaining popularity among skull base surgeons over the last decade.The surgery can be perfo...
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Elsevier
2025-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529425001195 |
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| author | Calvin Hoi-kwan Mak Ben Chat Fong Ng Stacey Carolyn Lam Tse Tat Shing Hunter Kwok-lai Yuen Hao-Chun Hsu Sebastien Froelich |
| author_facet | Calvin Hoi-kwan Mak Ben Chat Fong Ng Stacey Carolyn Lam Tse Tat Shing Hunter Kwok-lai Yuen Hao-Chun Hsu Sebastien Froelich |
| author_sort | Calvin Hoi-kwan Mak |
| collection | DOAJ |
| description | Introduction: To investigate the angle of attacks and surgical freedom in different extents of orbitotomy for Endoscopic Transorbital Approach to the skull base. Background: Endoscopic Transorbital Approach is gaining popularity among skull base surgeons over the last decade.The surgery can be performed with or without orbitotomy to increase surgical freedom for deeply seated intracranial lesion. Study design: This is an anatomical and radiological study in which DICOM data of CT Brain is retrieved and analyzed for 4 types of orbitotomies (Group 1: supraorbital rim with lateral orbital rim resection; Group 2: limited supraorbital rim with lateral orbital rim resection; Group 3: lateral orbital rim resection; Group 4: No orbitotomy) on both sides of 19 patients. Angle of attacks and surgical freedom were calculated with reference to three dimensional coordinates of 4 target points (1. Foramen ovale; 2. Foramen rotundum; 3. End of lacerum segment of internal carotid artery; 4. Internal acoustic meatus) and compared. Results: There is a statistically significant increase in surgical freedom, horizontal and vertical angle (p < 0.001) in Group 1 to 3 compared to Group 4 (No orbitotomy). With greater extent of orbitotomy, there is a larger increase in surgical freedom. Conclusion: Removal of lateral orbital rim is useful to increase the angle of attack to skull base lesions whereas the area of orbitotomy is the main determinant of surgical freedom in ETOA. Lateral orbital rim removal should be considered when ETOA is used for deep seated skull base pathologies. |
| format | Article |
| id | doaj-art-72ea4f03b9da4c5daa77709dcdfb526a |
| institution | Kabale University |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-72ea4f03b9da4c5daa77709dcdfb526a2025-08-20T03:30:41ZengElsevierBrain and Spine2772-52942025-01-01510430010.1016/j.bas.2025.104300Effect of orbitotomy on surgical freedom in Endoscopic Transorbital Approach (ETOA) to the skull base: An anatomical studyCalvin Hoi-kwan Mak0Ben Chat Fong Ng1Stacey Carolyn Lam2Tse Tat Shing3Hunter Kwok-lai Yuen4Hao-Chun Hsu5Sebastien Froelich6Department of Neurosurgery, Queen Elizabeth Hospital, Hong Kong, ChinaDepartment of Neurosurgery, Queen Elizabeth Hospital, Hong Kong, China; Corresponding author. Department of Neurosurgery, Queen Elizabeth Hospital, 30 Gascoigne Road, Kwoloon, Hong Kong, China.Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Neurosurgery, Queen Elizabeth Hospital, Hong Kong, ChinaDepartment of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, ChinaDivision of Neurosurgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin, TaiwanDepartment of Neurosurgery, Lariboisière Hospital, Paris, France; Paris VII-Diderot University, Paris, FranceIntroduction: To investigate the angle of attacks and surgical freedom in different extents of orbitotomy for Endoscopic Transorbital Approach to the skull base. Background: Endoscopic Transorbital Approach is gaining popularity among skull base surgeons over the last decade.The surgery can be performed with or without orbitotomy to increase surgical freedom for deeply seated intracranial lesion. Study design: This is an anatomical and radiological study in which DICOM data of CT Brain is retrieved and analyzed for 4 types of orbitotomies (Group 1: supraorbital rim with lateral orbital rim resection; Group 2: limited supraorbital rim with lateral orbital rim resection; Group 3: lateral orbital rim resection; Group 4: No orbitotomy) on both sides of 19 patients. Angle of attacks and surgical freedom were calculated with reference to three dimensional coordinates of 4 target points (1. Foramen ovale; 2. Foramen rotundum; 3. End of lacerum segment of internal carotid artery; 4. Internal acoustic meatus) and compared. Results: There is a statistically significant increase in surgical freedom, horizontal and vertical angle (p < 0.001) in Group 1 to 3 compared to Group 4 (No orbitotomy). With greater extent of orbitotomy, there is a larger increase in surgical freedom. Conclusion: Removal of lateral orbital rim is useful to increase the angle of attack to skull base lesions whereas the area of orbitotomy is the main determinant of surgical freedom in ETOA. Lateral orbital rim removal should be considered when ETOA is used for deep seated skull base pathologies.http://www.sciencedirect.com/science/article/pii/S2772529425001195Endoscopic transorbital surgeryOrbitotomySurgical freedom |
| spellingShingle | Calvin Hoi-kwan Mak Ben Chat Fong Ng Stacey Carolyn Lam Tse Tat Shing Hunter Kwok-lai Yuen Hao-Chun Hsu Sebastien Froelich Effect of orbitotomy on surgical freedom in Endoscopic Transorbital Approach (ETOA) to the skull base: An anatomical study Brain and Spine Endoscopic transorbital surgery Orbitotomy Surgical freedom |
| title | Effect of orbitotomy on surgical freedom in Endoscopic Transorbital Approach (ETOA) to the skull base: An anatomical study |
| title_full | Effect of orbitotomy on surgical freedom in Endoscopic Transorbital Approach (ETOA) to the skull base: An anatomical study |
| title_fullStr | Effect of orbitotomy on surgical freedom in Endoscopic Transorbital Approach (ETOA) to the skull base: An anatomical study |
| title_full_unstemmed | Effect of orbitotomy on surgical freedom in Endoscopic Transorbital Approach (ETOA) to the skull base: An anatomical study |
| title_short | Effect of orbitotomy on surgical freedom in Endoscopic Transorbital Approach (ETOA) to the skull base: An anatomical study |
| title_sort | effect of orbitotomy on surgical freedom in endoscopic transorbital approach etoa to the skull base an anatomical study |
| topic | Endoscopic transorbital surgery Orbitotomy Surgical freedom |
| url | http://www.sciencedirect.com/science/article/pii/S2772529425001195 |
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