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Transorbital approach: a bibliometric analysis from 1948 to 2024.

Alberto Di Somma^1,2,3, Héctor D Vargas-Moreno⁴, Marta Codes⁵

¹Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de La Salut, Universitat de Barcelona (UB), Barcelona, Spain. adisomma@clinic.cat.

Acta Neurochirurgica

|December 19, 2025

Summary

Transorbital surgery has evolved significantly, with a surge in endoscopic techniques since 2010. Research shows increased collaboration but limited clinical evidence for this minimally invasive approach.

Keywords:

Bibliometric ETOA Endoscopic skull base Endoscopic transorbital Minimally invasive Skull base Surgical techniques TONES Transorbital Transorbital approach

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Area of Science:

Neurosurgery
Medical History
Bibliometrics

Background:

Transorbital surgery has a complex history, including controversial uses and evolving techniques.
The development of neuroendoscopic transorbital procedures marks a recent significant advancement.
This review focuses on the period from 1948 to 2024, emphasizing the last two decades.

Purpose of the Study:

To analyze the historical evolution of transorbital surgery from 1948 to 2024.
To assess the impact and emerging trends, particularly the endoscopic transorbital approach (eTOA).
To utilize scientometric techniques for a comprehensive overview.

Main Methods:

Searched Web of Science Core Collection for "Transorbital" publications (1948-2024).
Analyzed data using bibliometric tools (R, Python, VOSviewer) and statistical software.
Examined publication trends, keyword evolution, institutional/geographic output, collaborations, and gender distribution.

Main Results:

538 publications were analyzed, with 64% published after 2010, indicating a surge in activity.
A thematic shift occurred from ischemia models to endoscopic applications.
Top institutions and countries identified; international collaboration and female author underrepresentation noted.

Conclusions:

Transorbital surgery is now a versatile, minimally invasive route with a growing research base.
Despite increased research, prospective clinical evidence for transorbital approaches remains limited.
This bibliometric review provides insights into historical trends, current research, and future directions.