Transorbital neuroendoscopic surgery for treatment of sphenoid wing meningiomas extending to the cavernous sinus: clinical implications and a technical illustration

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dc.contributor.authorKarımzada, G.
dc.contributor.authorKarımzada, D.E.
dc.contributor.authorErol, G.
dc.contributor.authorGülsuna, B.
dc.contributor.authorKuzucu, P.
dc.contributor.authorGüngör, A.
dc.contributor.authorKutlay A.M.
dc.date.accessioned2024-05-19T14:33:35Z
dc.date.available2024-05-19T14:33:35Z
dc.date.issued2024
dc.departmentİstinye Üniversitesien_US
dc.description.abstractOBJECTIVE The aim of this study was to evaluate the efficacy and safety of transorbital neuroendoscopic surgery (TONES) in the management of sphenoid wing meningiomas (SWMs) with cavernous sinus and orbital invasion. METHODS The authors conducted a retrospective review of 32 patients with SWMs treated at Gazi University using TONES from October 2019 to May 2023. The study includes clinical applications to elucidate the endoscopic transorbital approach. Surgical techniques focused on safe subtotal resection, aiming to minimize residual tumor volume for subsequent radiosurgery. Data were collected on patient demographics, tumor characteristics, surgical procedures, complications, and postoperative outcomes, including radiological imaging and ophthalmological evaluations. RESULTS Surgical dissections delineated a three-phase endoscopic transorbital approach: extraorbital, intraorbital, and intracranial. In the clinical application, gross-total resection was not achieved in any patient because of planned postoperative Gamma Knife radiosurgery. The mean follow-up period was 16.3 months. Of 30 patients with preoperative proptosis, 25 experienced postoperative improvement. No new-onset extraocular muscle paresis or visual loss occurred postoperatively. The average hospital stay was 1.15 days, with minimal complications and no significant morbidity or mortality. CONCLUSIONS Total resection of SWMs invading the cavernous sinus and orbit is associated with substantial risks, particularly cranial nerve deficits. TONES offers a minimally invasive alternative, reducing morbidity compared with transcranial approaches, and represents a significant advancement in the surgical management of SWMs, especially those extending into the cavernous sinus and orbit. The approach provides a safe, effective, and patient-centric approach, prioritizing subtotal resection to minimize neurological deficits while preparing patients for adjunctive radiosurgery. This study positions TONES as a transformative surgical technique, aligning therapeutic efficacy with neurovascular preservation and postoperative recovery. © AANS 2024, except where prohibited by US copyright lawen_US
dc.identifier.doi10.3171/2024.1.FOCUS23857
dc.identifier.issn1092-0684
dc.identifier.issue4en_US
dc.identifier.pmid38560930en_US
dc.identifier.scopus2-s2.0-85189780362en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.3171/2024.1.FOCUS23857
dc.identifier.urihttps://hdl.handle.net/20.500.12713/4278
dc.identifier.volume56en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherAmerican Association of Neurological Surgeonsen_US
dc.relation.ispartofNeurosurgical Focusen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmz20240519_kaen_US
dc.subjectCavernous Sinusen_US
dc.subjectNeuroendoscopyen_US
dc.subjectSphenoid Wing Meningiomasen_US
dc.subjectTransorbital Surgeryen_US
dc.titleTransorbital neuroendoscopic surgery for treatment of sphenoid wing meningiomas extending to the cavernous sinus: clinical implications and a technical illustrationen_US
dc.typeArticleen_US

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