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The endoscopic supraorbital translaminar approach: a technical note.

Rafael Martinez-Perez1, Thiago Albonette-Felicio2, Douglas A Hardesty2,3

  • 1Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, 410 W. 10th Ave., N-1049 Doan Hall, Columbus, OH, 43210, USA. rafa11safin@hotmail.com.

Acta Neurochirurgica
|July 22, 2020
PubMed
Summary

The endoscopic supraorbital translaminar approach (ESTA) offers a viable endoscopic solution for accessing third ventricle lesions. This minimally invasive technique provides excellent visualization and maneuverability, crucial for complex neurosurgical procedures.

Keywords:
AnatomyAneurysmEyebrowHydrocephalusKeyholeSkull baseSupraorbital

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Area of Science:

  • Neurosurgery
  • Minimally Invasive Surgery
  • Endoscopic Techniques

Background:

  • Resection of third ventricle lesions is surgically challenging.
  • Minimizing brain retraction is critical during these procedures.
  • Novel approaches are needed to improve surgical outcomes.

Purpose of the Study:

  • To evaluate the surgical exposure and maneuverability of the endoscopic supraorbital translaminar approach (ESTA).
  • To assess ESTA as a potential alternative for accessing the third ventricle.
  • To compare ESTA with traditional fenestration of the lamina terminalis.

Main Methods:

  • Utilized five cadaveric heads for assessing corridor depth, exposure area, and viewing angles.
  • Performed stepwise dissection on an additional specimen.
  • Focused on the keyhole supraorbital-eyebrow craniotomy and endoscopic visualization.

Main Results:

  • The ESTA was successfully performed in all specimens.
  • Demonstrated significant corridor depth to key anatomical structures (ICA, lamina terminalis).
  • Provided a wide surgical exposure area (1655 ± 255 mm²) and effective viewing angles.

Conclusions:

  • The ESTA offers a broad surgical view of the lamina terminalis.
  • This approach is suitable for lesions in the anterior third of the third ventricle.
  • ESTA enables minimal brain retraction and straightforward access to target structures.