Endoscopic transorbital surgery for Meckel's cave and middle cranial fossa tumors: surgical technique and early results.

摘要: OBJECTIVETumors involving Meckel's cave remain extremely challenging because of the surrounding complex neurovascular structures and deep-seated location. The authors investigated a new minimal-access technique using endoscopic transorbital approach (eTOA) through superior eyelid crease to middle cranial fossa lesions reviewed most useful surgical procedures pitfalls this approach.METHODSBetween September 2016 January 2018, performed eTOA in 9 patients with tumors fossa. included trigeminal schwannoma 4 patients, meningioma 2 metastatic brain tumor 1 patient, chondrosarcoma dermoid cyst patient. In 7 alone was performed, while other underwent combined endonasal or retrosigmoid craniotomy. Data including details techniques clinical outcomes were recorded.RESULTSGross-total resection (77.8%). Four extended (with lateral orbital rim osteotomy). Drilling trapezoid sphenoid floor, "peeling" technique, full visualization applied lesions. Tumors exposed removed extradurally 3 intradurally 6 patients. There no postoperative CSF leak.CONCLUSIONSThe affords direct route access With experience, novel can be successfully selected skull base To achieve successful removal tumor, emphasis should placed on importance adequately removing greater wing vertical crest. However, limited working space may not an ideal for posterior