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Lateral Transorbital Endoscopic Access to the Hippocampus, Amygdala, and Entorhinal Cortex: Initial Clinical
H Isaac Chen1, Leif-Erik Bohman, Lyndsey Emery
1Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa., USA.
ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties
|September 30, 2015
Summary
The endoscope-assisted lateral transorbital approach provides a novel surgical route to the temporal lobe, offering adequate access for treating mesial temporal lobe pathology. This minimally invasive technique shows promise for future neurosurgical interventions.
Area of Science:
- Neurosurgery
- Minimally Invasive Surgery
- Endoscopic Techniques
Background:
- Traditional transorbital approaches target skull base and cavernous sinus lesions medial to the globe.
- Lateral orbital approaches to the temporal lobe are less explored but offer theoretical advantages over craniotomy.
- Previous cadaveric studies demonstrated the feasibility of a lateral transorbital technique with endoscopic visualization.
Observation:
- Two patients with mesial temporal lobe epilepsy underwent surgery.
- A transpalpebral or eyebrow incision provided intraorbital access.
- A lateral orbital keyhole opening allowed visualization of the anterior temporal pole.
Findings:
- The endoscope-assisted lateral transorbital approach provided adequate surgical access.
- The technique was well-tolerated by patients.
- This represents the first clinical case series of this specific approach.
Implications:
- This approach may offer advantages over open craniotomy for temporal lobe pathologies.
- Further prospective studies are needed to compare outcomes with traditional methods.
- This technique expands the utility of transorbital surgery for deeper brain lesions.
