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Endoscopic Transorbital Approach to Mesial Temporal Lobe for Intra-Axial Lesions: Cadaveric Study and Case Series (SevEN-008)

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dc.contributor.authorPark, HH-
dc.contributor.authorRoh, TH-
dc.contributor.authorChoi, S-
dc.contributor.authorYoo, J-
dc.contributor.authorKim, WH-
dc.contributor.authorJung, IH-
dc.contributor.authorYun, IS-
dc.contributor.authorHong, CK-
dc.date.accessioned2023-01-10T00:39:15Z-
dc.date.available2023-01-10T00:39:15Z-
dc.date.issued2021-
dc.identifier.issn2332-4252-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/23922-
dc.description.abstractBACKGROUND: Endoscopic transorbital approach (ETOA) has been proposed as a minimally invasive technique for the treatment of skull base lesions located around mesial temporal lobe (MTL), mostly extra-axial pathology. OBJECTIVE: To explore the feasibility of ETOA in accessing intraparenchymal MTL with cadaveric specimens and describe our initial clinical experience of ETOA for intra-axial lesions in MTL. METHODS: Anatomic dissections were performed in 4 adult cadaveric heads using a 0° endoscope. First, a stepwise anatomical investigation of ETOA to intraparenchymal MTL was explored. Then, ETOA was applied clinically for 7 patients with intra-axial lesions in MTL, predominantly high-grade gliomas (HGGs) and low-grade gliomas (LGGs). RESULTS: The extradural stage of ETOA entailed a superior eyelid incision followed by orbital retraction, drilling of orbital roof, greater and lesser wing of sphenoid bone, and cutting of the meningo-orbital band. For the intradural stage, the brain tissue medial to the occipito-temporal gyrus was aspirated until the temporal horn was opened. The structures of MTL could be aspirated selectively in a subpial manner without injury to the neurovascular structures of the ambient and sylvian cisterns, and the lateral neocortex. After cadaveric validation, ETOA was successfully performed for 4 patients with HGGs and 3 patients with LGGs. Gross total resection was achieved in 6 patients (85.7%) without significant surgical morbidities including visual field deficits. CONCLUSION: ETOA provides a logical line of access for intra-axial lesions in MTL. The safe and natural surgical trajectory of ETOA can spare brain retraction, neurovascular injury, and disruption of the lateral neocortex.-
dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHCadaver-
dc.subject.MESHEndoscopy-
dc.subject.MESHHumans-
dc.subject.MESHSkull Base-
dc.subject.MESHSphenoid Bone-
dc.subject.MESHTemporal Lobe-
dc.titleEndoscopic Transorbital Approach to Mesial Temporal Lobe for Intra-Axial Lesions: Cadaveric Study and Case Series (SevEN-008)-
dc.typeArticle-
dc.identifier.pmid34528091-
dc.subject.keywordCadaveric study-
dc.subject.keywordCase series-
dc.subject.keywordEndoscopic transorbital approach-
dc.subject.keywordIntra-axial-
dc.subject.keywordMesial temporal lobe-
dc.contributor.affiliatedAuthorRoh, TH-
dc.type.localJournal Papers-
dc.identifier.doi10.1093/ons/opab319-
dc.citation.titleOperative neurosurgery (Hagerstown, Md.)-
dc.citation.volume21-
dc.citation.number6-
dc.citation.date2021-
dc.citation.startPageE506-
dc.citation.endPageE515-
dc.identifier.bibliographicCitationOperative neurosurgery (Hagerstown, Md.), 21(6). : E506-E515, 2021-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn2332-4260-
dc.relation.journalidJ023324252-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
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