Transpalpebral approach in skull base surgery: how I do it

Dzhindzhikhadze, R. S.; Dreval, О. N.; Lazarev, V. A.; Polyakov, A. V.

doi:10.1007/s00701-018-3724-4

Cited by 9 publications

(10 citation statements)

References 5 publications

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“…We assessed the functional and cosmetic outcomes, surgical complications and concluded that TPA could be successfully performed as an alternative method to traditional extended approaches and endoscopic routes in the skull base surgery. [38][39][40] In this report, we presented outcomes in 15 patients diagnosed with TSM. A surgical approach was selected with critical assessment of facial and bone anatomy, sizes of the tumor.…”

Section: Discussionmentioning

confidence: 99%

Transpalpebral approach for microsurgical removal of tuberculum sellae meningiomas

et al. 2020

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Background: The evolution of skull base approaches associated with individualization of surgical corridor and minimizing the collateral damage. Achieving the radical removal of tumor and preserving the neurological status of the patient is possible, both with the traditional approaches and keyhole approaches. Our work presents experience using the transpalpebral approach (TPA) for microsurgical removal of tuberculum sellae meningioma (TSM). Materials and Methods: A total of 15 patients with meningiomas underwent microsurgical removal of TSM through TPA. Ten patients were women and five were men. The standard preoperative diagnostic protocol includes magnetic resonance imaging with contrast enhancement, brain computed tomography for neuronavigation. We assess surgical complications, functional and cosmetic outcomes, and surgical parameters, including the time of surgery and intraoperative blood loss. Results: Visual impairment was finding in 100% patients, including slight decrease of vision (46,7%, seven patients), partial vision field loss (six patients, 40%), and serious visual impairment (two patients 13.3%). Visual improvement was noted in ten cases (66.7%), there was no improvement in four cases (26.7%), and one case (6.6%) had transient visual worsening for 4 days and slow improvement in 1 month. Headache disappeared in three patients (50%). There were no cases of cerebrospinal fluid leak. Transient frontal hypoesthesia was noted in all patients (100%) without permanent deficit. Transient palsy of the frontal muscle was noted in four patients for 4–6 months. Histological examination revealed WHO Grade I meningioma in 14 cases and in 1 case WHO Grade II meningioma. No deaths were identified in follow-up at 12 months. The average value of the Modified Rankin Scale was 1.4. The mean length of stay in hospital was 5. Conclusion: TPA is technically difficult and requires some experience to work in deep structures in a small surgical corridor. This technique can be good alternative to traditional fronto-lateral, supraorbital keyhole craniotomies, and endoscopic endonasal approaches.

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Section: Discussionmentioning

confidence: 99%

Transpalpebral approach for microsurgical removal of tuberculum sellae meningiomas

et al. 2020

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“…12 It also provides a pathway to expose the anterior cranial fossa, parasellar space, and frontal sinus. 13 The transpalpebral incision, adopted from oculoplastics, has been paired with many keyhole or minimally invasive approaches,…”

Section: Transpalpebral Approachmentioning

confidence: 99%

“…Additionally, the approach confines trajectory options and may have inadequate illumination. 13 Several potential complications have been reported including periorbital edema, cerebrospinal fluid (CSF) leak, and eyelid hematomas. 12,16 Careful preoperative planning is important in reducing morbidity and complications.…”

Section: Approach Limitations and Complicationsmentioning

confidence: 99%

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Surgical Approaches to the Orbit: A Neurosurgical Perspective

Abussuud

Ahmed

Paluzzi

2020

J Neurol Surg B Skull Base

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“…[8] e SOA has important neurosurgical considerations regarding different approaches and bypasses. is importance lies in its involvement in lesions such as aneurysms, [2,6,7,12,13,16,18] and its incorporation in reconstruction flaps for skull base and skin defects. [5,10,14,19] e SOA is poorly described in the standard anatomical textbooks.…”

Section: Introductionmentioning

confidence: 99%

Supraorbital artery: Anatomical variations and neurosurgical applications

Kareem,

Muthana,

Hassan

et al. 2023

Surgical Neurology International

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Background: The supraorbital artery (SOA) originates from the ophthalmic artery in a superomedial aspect of the orbit, exiting through the supraorbital groove to emerge onto the forehead. The SOA has important neurosurgical considerations regarding different approaches and bypasses. The SOA is poorly described in the standard anatomical textbooks. Therefore, we present this article to describe the anatomical variations of the SOA and their implications on the neurosurgical field. Methods: We conducted a literature review in PubMed and Google Scholar databases to review the existing literature describing the SOA anatomy and its neurosurgical applications. Results: While reading the available articles and original works regarding SOA, we identified 22 studies that discuss the SOA. We noticed the anatomical variations of the SOA in terms of origin, course, diameter, branches, depth, and distance in relation to the midline and vertical glabellar line. We also discussed certain applications of SOA and its importance in neurosurgical approaches, bypass, photoplethysmography, aneurysms, and reconstruction of cranial fossa defects. Conclusion: The variable anatomy of the SOA has a paramount impact on performing different neurosurgical approaches. Therefore, cadaveric studies of the SOA are important to explore potential methods for the preservation of the artery in different neurosurgical applications.

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Transpalpebral approach in skull base surgery: how I do it

Cited by 9 publications

References 5 publications

Transpalpebral approach for microsurgical removal of tuberculum sellae meningiomas

Transpalpebral approach for microsurgical removal of tuberculum sellae meningiomas

Surgical Approaches to the Orbit: A Neurosurgical Perspective

Supraorbital artery: Anatomical variations and neurosurgical applications

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