“Round the clock”: Surgical access to the orbital apex pathologies

2020 ◽  
pp. 1-2
Keyword(s):  
Orbital Apex ◽  
Surgical Access

Endoscopic Endonasal Approaches to the Cavernous Sinus: Surgical Approaches

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 354-362 ◽  
Author(s):  
Alessandra Alfieri ◽  
Hae-Dong Jho
Keyword(s):  
Cavernous Sinus ◽  
Middle Turbinate ◽  
Lateral Wall ◽  
Surgical Instruments ◽  
Surgical Approaches ◽  
Lateral Nasal Wall ◽  
Orbital Apex ◽  
Superior Orbital Fissure ◽  
Endoscopic Endonasal ◽  
Surgical Access

Abstract OBJECTIVE After completion of an earlier endoscopic transsphenoidal anatomic study, we studied various endoscopic transsphenoidal approaches using cadaveric specimens to develop endoscopic endonasal surgical approaches to the cavernous sinus. METHODS Ten cavernous sinuses in five artery-injected adult cadaveric heads were studied with 0-, 30-, and 70-degree angled 4-mm rod-lens endoscopes. The extent of the surgical exposure, the skewed endoscopic anatomic view, and the maneuverability of surgical instruments through their relative operating spaces were studied after various endoscopic endonasal approaches via one nostril. RESULTS The paraseptal approach was used between the nasal septum and the middle turbinate and provided exposure at the anteromedial portion of the cavernous sinus. The contralateral paraseptal approach rendered a slightly more medial view at the cavernous sinus than did the ipsilateral approach. This approach offered limited surgical access to the lateral vertical compartment. The middle turbinectomy approach allowed surgical access to the lateral wall of the cavernous sinus, except for the superior orbital fissure and the orbital apex. The middle meatal approach, which was made between the middle turbinate and the lateral nasal wall, revealed the entire lateral vertical compartment of the cavernous sinus, including the orbital apex and the superior orbital fissure. However, its lateral tangential surgical trajectory and the absence of dedicated surgical tools limited the surgeon's surgical maneuverability. A combination of the middle turbinectomy and middle meatal approaches increased the operating space. CONCLUSION Various endoscopic endonasal surgical approaches to the cavernous sinus were studied using adult cadaveric head specimens.

scholarly journals Orbital apex osteodural fistula - An unusual surgical access

2015 ◽  
Vol 63 (9) ◽  
pp. 746
Author(s):  
Hemant Trehan ◽  
Rajeev Sivasankar ◽  
Sanjiv Agrawal ◽  
Merlin Saldanha ◽  
Nikita Sonawane ◽  
...  
Keyword(s):  
Orbital Apex ◽  
Surgical Access

What Are the Tips on Surgery for Orbital Apex Lesion?

2019 ◽  
Author(s):  
Yoshihiro Natori
Keyword(s):  
Orbital Apex

Orbital apex syndrome secondary to nasopharyngeal carcinoma

2015 ◽  
Vol 4 (2) ◽  
pp. 177
Author(s):  
CS Sandhya ◽  
DMurali Krishna ◽  
C Jagannath ◽  
G Srinivas ◽  
K Radhika
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Orbital Apex ◽  
Orbital Apex Syndrome

CONGENITAL HYPERTROPHIC PYLORIC STENOSIS: EVOLUTION OF SURGICAL ACCESS ON THE EXAMPLE OF 298 OPERATIONS

2017 ◽  
Vol 96 (3) ◽  
pp. 130-137
Author(s):  
Y. A. Kozlov ◽  
◽  
V. A. Novozhilov ◽  
A. A. Rasputin ◽  
K. A. Kovalkov ◽  
...  
Keyword(s):  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Surgical Access ◽  
Congenital Hypertrophic Pyloric Stenosis

Holmes tremor: a delayed complication after resection of brainstem cavernomas

2020 ◽  
pp. 1-11
Author(s):  
Marco Cenzato ◽  
Davide Colistra ◽  
Giorgia Iacopino ◽  
Christian Raftopoulos ◽  
Ulrich Sure ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Neurophysiological Monitoring ◽  
Strict Adherence ◽  
Surgical Access ◽  
Holmes Tremor ◽  
Neurophysiological Studies ◽  
Metropolitan Hospital ◽  
Delayed Complication ◽  
Brainstem Cavernoma ◽  
Predicting Factor

OBJECTIVEIn this paper, the authors aimed to illustrate how Holmes tremor (HT) can occur as a delayed complication after brainstem cavernoma resection despite strict adherence to the safe entry zones (SEZs).METHODSAfter operating on 2 patients with brainstem cavernoma at the Great Metropolitan Hospital Niguarda in Milan and noticing a similar pathological pattern postoperatively, the authors asked 10 different neurosurgery centers around the world to identify similar cases, and a total of 20 were gathered from among 1274 cases of brainstem cavernomas. They evaluated the tremor, cavernoma location, surgical approach, and SEZ for every case. For the 2 cases at their center, they also performed electromyographic and accelerometric recordings of the tremor and evaluated the postoperative tractographic representation of the neuronal pathways involved in the tremorigenesis. After gathering data on all 1274 brainstem cavernomas, they performed a statistical analysis to determine if the location of the cavernoma is a potential predicting factor for the onset of HT.RESULTSFrom the analysis of all 20 cases with HT, it emerged that this highly debilitating tremor can occur as a delayed complication in patients whose postoperative clinical course has been excellent and in whom surgical access has strictly adhered to the SEZs. Three of the patients were subsequently effectively treated with deep brain stimulation (DBS), which resulted in complete or almost complete tremor regression. From the statistical analysis of all 1274 brainstem cavernomas, it was determined that a cavernoma location in the midbrain was significantly associated with the onset of HT (p < 0.0005).CONCLUSIONSDespite strict adherence to SEZs, the use of intraoperative neurophysiological monitoring, and the immediate success of a resective surgery, HT, a severe neurological disorder, can occur as a delayed complication after resection of brainstem cavernomas. A cavernoma location in the midbrain is a significant predictive factor for the onset of HT. Further anatomical and neurophysiological studies will be necessary to find clues to prevent this complication.

Improvement of surgical access in autogenous infrainguinal reconstruction by the method «in situ»

2018 ◽  
Vol 16 (7(part 2)) ◽  
pp. 81-85
Author(s):  
M. V. Plotnikov ◽  
◽  
A. V. Maksimov ◽  
Keyword(s):  
Surgical Access

SIMULTANEOUS ESOPHAGO-GASTRECTOMY WITH COLONIC INTERPOSITION AS A METHOD OF SURGICAL TREATMENT OF GASTROESOPHAGEAL CANCER WITH HIGH INVOLVEMENT OF THE ESOPHAGUS

2017 ◽  
Vol 63 (1) ◽  
pp. 146-152
Author(s):  
Mikhail Ter-ovanesov ◽  
Aleksandr Levitskiy ◽  
E. Lesnidze ◽  
Aram Gaboyan ◽  
Mariya Kukosh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Long Term Results ◽  
Esophageal Reconstruction ◽  
Gastroesophageal Cancer ◽  
Colonic Interposition ◽  
Simultaneous Application ◽  
High Involvement ◽  
Surgical Access ◽  
Critical Overview

In the current oncological practice surgical treatment of gastroesophageal cancer with high involvement of the esophagus can extend to total esophago-gastrectomy with colonic interposition as the main method of radical treatment. However the technical complexity and high risk of the intervention are factors in determining the divergent views on the operation itself, testimony for the criteria of patient’s selection, choice of surgical access and the formation of a colonic graft in conjunction with method of esophageal reconstruction. The long-term results of operative intervention depend primarily on the extent of tumor process but obviously higher than after conservative treatment. This article presents a brief critical overview of the main aspects of the simultaneous application of esophago-gastrectomy in surgery of gastroesophageal cancer with high esophageal involvement and our clinical case of successful surgical treatment of a woman with pregnancy-associated gastroesophageal cancer.

scholarly journals Orbital apex syndrome in COVID-19 patient, a case report

2021 ◽  
pp. 101006
Author(s):  
Masood Bagheri ◽  
Ahad Jafari ◽  
Sasan Jafari
Keyword(s):  
Case Report ◽  
Orbital Apex ◽  
Orbital Apex Syndrome
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