3D exoscopic surgery of lateral skull base

Rubini, Alessia; Gioia, Stefano Di; Marchioni, Daniele

doi:10.1007/s00405-019-05736-7

Cited by 44 publications

(72 citation statements)

References 12 publications

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“…The high-intensity lighting may result in homogenization of colors and diminished ability for anatomic distinction. 8 Furthermore, for lateral skull base surgery, subjective reports of decreased image quality and depth perception compared with the operative microscope have been documented 6,12 ; however, the surgeon in our case series does not find these to be limitations.…”

Section: Discussionmentioning

confidence: 66%

Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer

Raymond

Soriano

Belcher

et al. 2021

J Neurol Surg B Skull Base

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Objectives The three-dimensional (3D) exoscope has several advantages over the operative microscope (OM) but has not been extensively reported for its use in malignant temporal bone resections (TBR). We sought to demonstrate the feasibility of performing TBR, both lateral (LTBR) and subtotal (STBR), using the 3D exoscope for head and neck cancers. Design present study is a retrospective chart review from August 2016 until August 2019. Setting The study was conducted at a tertiary care center. Participants Patients were undergoing TBR with the Karl Storz VITOM 3D exoscope. Main Outcome Measures Demographics, tumor and surgical characteristics, patient outcomes were the primary measurements of this study. Results Fifty-five patients underwent 3D exoscopic TBR from 2016 through 2019 of which 18% (n = 10) underwent STBR. The 3D exoscope was used uninterruptedly in all procedures with no intraoperative complications. Most tumors were primarily T3 (42%, n = 23) or T4 (55%, n = 30) and of cutaneous (62%, n = 34) and parotid (27%, n = 15) origin. These TBR were often accompanied by infratemporal fossa resections (87%, n = 48), auriculectomies (47%, n = 26), mandibulectomies (53%, n = 29), and parotidectomies (96%, n = 53). On final pathology, 24% (n = 13) had microscopically positive margins. Over the study period, 20% (n = 11) of patients had recurrences with a median recurrence time of 5 months (range: 2–30 months). Conclusion In the largest case series of LTBR and STBR under exclusive 3D exoscopic visualization to date, we demonstrate the 3D exoscope is a feasible alternative to the operative microscope for LTBR and STBR. While oncologic outcomes remain to be clarified, it carries significant potential for use in complex oncologic procedures.

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Section: Discussionmentioning

confidence: 66%

Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer

Raymond

Soriano

Belcher

et al. 2021

J Neurol Surg B Skull Base

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“… 28 , 31 , 32 Reports have demonstrated successful use of the exoscope in cochlear implantation, mastoidectomies, vestibular schwannoma resections, temporal lobe encephaloceles, and cholesteatomas. 27 , 33 , 34 , 35 …”

Section: Discussionmentioning

confidence: 99%

Heads-up Surgery

Ridge

Shetty

Lee

2021

Otolaryngologic Clinics of North America

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Synopsis A new era of surgical visualization and magnification is poised to disrupt the field of otology and neurotology. The once revolutionary benefits of the binocular microscope are now shared with rigid endoscopes and exoscopes. These two modalities are complementary. The endoscope improves visualization of the hidden recesses through the external auditory canal or canal up mastoidectomy. The exoscope provides an immersive visual experience and superior ergonomics compared to binocular microscopy. Endoscopes and exoscopes are poised to disrupt the standard of care for surgical visualization and magnification in otology and neurotology.

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“…When the 3D-HD system of vision is employed in particular settings, as for oral cavity or oropharyngeal lesions [ 9 ], or reconstructive surgery [ 10 ], or otoneurosurgery [ 11 ], where micromanipulator for the CO 2 laser is not needed, traditional cold instruments, monopolar scalpels, or fiber lasers can be employed as cutting devices. The disposition of the nurse’s master table and secondary table, as well as the anesthesia device or other surgical devices in the operatory room, is not further influenced by the application of this setting and is totally similar to a traditional procedure.…”

Section: The Vitom® 3d-hd Exoscopic Systemmentioning

confidence: 99%

“…This system is broad suitable also for otoneurosurgical, [ 11 , 14 ], neurosurgical [ 15 ] and reconstructive procedures [ 10 ], being its unique limit the coupling with the CO 2 laser micromanipulator, required for transoral laser microsurgery, that we managed with the above-mentioned coupling system.…”

Section: Perspectivesmentioning

confidence: 99%

Microsurgical procedures during COVID-19 pandemic: the VITOM® 3D-HD exoscopic system as alternative to the operating microscope to properly use personal protective equipment (PPE)

Carobbio

Filauro

Parrinello

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose In the field of microsurgery, the use of conventional operating microscope, adopted in several disciplines, is not suitable with the full adoption of appropriate personal protective equipment (PPE), as goggles and face shields, needing the eyes to be at close contact with oculars. Methods Herein we present an exoscopic surgical setup, implemented for transoral laser microsurgery, by the VITOM® 3D-HD system. Results Our proposed exoscopic setting overcomes safety limits of the conventional operating microscope, being suitable with the adoption of full PPE necessary facing with suspected or confirmed positive SARS-CoV-2 patients needing urgent microsurgical procedures. Conclusion The use of protocols to reduce the virus spreading is mandatory to safely treat also patients potentially SARS-CoV-2 infected. The described surgical setup is advisable to manage urgent microsurgical procedures along the duration of the COVID-19 pandemic, being applicable PPE necessary to treat potentially or confirmed SARS-CoV-2-infected patients.

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3D exoscopic surgery of lateral skull base

Cited by 44 publications

References 12 publications

Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer

Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer

Heads-up Surgery

Microsurgical procedures during COVID-19 pandemic: the VITOM® 3D-HD exoscopic system as alternative to the operating microscope to properly use personal protective equipment (PPE)

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