Transorbital approach to the cavernous sinus: an anatomical study of the related cranial nerves.

Background: The cavernous sinus (CS) is a demanding surgical territory, given its deep location and the involvement of multiple neurovascular structures. Subjected to recurrent discussion on the optimal surgical access, the endoscopic transorbital approach has been recently proposed as a feasible route for selected lesions in the lateral CS. Still, for this technique to safely evolve and consolidate, a comprehensive anatomical description of involved cranial nerves, dural ligaments, and arterial relations is needed.

Endonasal versus supraorbital approach for anterior skull base meningiomas: Results and quality of life assessment from a single-surgeon cohort.

Objective: In this prospective non-randomized study we reported our experience related to planum sphenoidale (PS) and tuberculum sellae (TS) meningiomas in a similar cohort of patients operated via the endonasal or the supraorbital route. A comprehensive quality of life analysis has been performed.

Methods: Being comparable in general features, between November 2017 to January 2020, a total of 20 patients with anterior skull base meningioma were included.

Endoscopic transorbital resection of the temporal lobe: anatomic qualitative and quantitative study.

Objective: Starting from an anatomic study describing the possibility of reaching the temporal region through an endoscopic transorbital approach, many clinical reports have now demonstrated the applicability of this strategy when dealing with intra-axial lesions. The study aimed to provide both a qualitative anatomic description of the temporal region, as seen through a transorbital perspective, and a quantitative analysis of the amount of temporal lobe resection achievable via this route.

Material And Methods: A total of four cadaveric heads (eight sides) were dissected at the Laboratory of Surgical Neuroanatomy (LSNA) of the University of Barcelona, Spain.

Multiportal Combined Endoscopic Endonasal and Transorbital Pathways: Qualitative and Quantitative Anatomic Studies of the "Connection" Skull Base Areas.

Background: Combined endonasal and transorbital multiportal surgery has been recently described for selected skull base pathologies. Nevertheless, a detailed anatomic description and a quantitative comprehensive anatomic study of the skull base areas where these 2 endoscopic routes converge, a so-called connection areas, are missing in the scientific literature.

Objective: To identify all the skull base areas and anatomic structures where endonasal and transorbital endoscopic avenues could be connected and combined.

Superior eyelid endoscopic transorbital approach to the tentorial area: A qualitative and quantitative anatomic study.

Objective: Superior eyelid endoscopic transorbital approach (SETOA) is nowadays gaining progressive application in neurosurgical scenarios. Both anatomic and clinical reports have demonstrated the possibility of taking advantage of the orbital corridor as a minimally invasive route to reach anterior and middle cranial fossae and manage selected surgical lesions developing in these areas. The aim of this paper is to further shed light on other anatomic regions of the skull base as seen from a transorbital perspective, namely, the posterior cranial fossa and tentorial area, describing technical feasibility and steps in reaching this area through an extradural-transtentorial approach and providing quantitative evaluations of the "working area" obtained through this route.

Endoscopic Anatomy of Transcallosal Hemispherotomy: Laboratory Study with Advanced Three-Dimensional Modeling.

Background: Epilepsy surgery has an important role in the treatment of patients with medically intractable seizures. Various authors have proposed an endoscopic technique to perform disconnective procedures. A detailed description of intracerebral anatomy seen through an endoscopic transcallosal corridor has not been reported.

Minimally Invasive Surgical Technique for the Management of Giant Dumbbell Spinal Schwannoma.

Background:  Completely extradural spinal schwannomas have a unique morphology (dumbbell tumors) with an intra- and extraspinal component. When they compromise two contiguous vertebral bodies or have an extraspinal extension >2.5 cm, they are classified as giant spinal schwannomas.

Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma Surgery.

Object: Low-field intraoperative magnetic resonance (LF-iMR) has demonstrated a slight increase in the extent of resection of intra-axial tumors while preserving patient`s neurological outcomes. However, whether this improvement is cost-effective or not is still matter of controversy. In this clinical investigation we sought to evaluate the cost-effectiveness of the implementation of a LF-iMR in glioma surgery.

Endoscopic endonasal and transorbital routes to the petrous apex: anatomic comparative study of two pathways.

Background And Objective: Surgical approaches to the petrous apex region are extremely challenging; while subtemporal approaches and variations represent the milestone of the surgical modules to reach such deep anatomical target, in a constant effort to develop minimally invasive neurosurgical routes, the endoscopic endonasal approach (EEA) has been tested to get a viable corridor to the petroclival junction. Lately, another ventral endoscopic minimally invasive route, i.e.

Combined Use of 5-Aminolevulinic Acid and Intraoperative Low-Field Magnetic Resonance Imaging in High-Grade Glioma Surgery.

Objective: We sought to assess the impact of 5-aminolevulinic acid (5-ALA) and low-field intraoperative magnetic resonance imaging (iMRI) on the extent of resection of high-grade gliomas (HGGs). Results are compared with those obtained when using 5-ALA and iMRI separately.

Methods: We retrospectively included patients with an HGG eligible for gross total resection (GTR) from January 2013 to January 2018.

Extended endoscopic endonasal surgery for clival chordoma and chondrosarcoma: Our experience in 14 cases.

Objective: To report our experience in the management of chordoma and chondrosarcoma with extended endoscopic endonasal surgery.

Method: We performed a retrospective analysis of a series of 14 patients with clival chordoma or chondrosarcoma who had extended endoscopic endonasal surgery from 2008 to 2016 performed by the same multidisciplinary team.

Results: We had fourteen patients (male/female 2:1), with a mean age of 49years for chordoma and 32 for chondrosarcoma.

Defining the lateral limits of the endoscopic endonasal transtuberculum transplanum approach: anatomical study with pertinent quantitative analysis.

Objective: The extended endoscopic endonasal transtuberculum transplanum approach is currently used for the surgical treatment of selected midline anterior skull base lesions. Nevertheless, the possibility of accessing the lateral aspects of the planum sphenoidale could represent a limitation for such an approach. To the authors' knowledge, a clear definition of the eventual anatomical boundaries has not been delineated.

Does Low-Field Intraoperative Magnetic Resonance Improve the Results of Endoscopic Pituitary Surgery? Experience of the Implementation of a New Device in a Referral Center.

Objective: To assess the contribution of low-field intraoperative magnetic resonance (iMRI) to endoscopic pituitary surgery.

Methods: We analyzed a prospective series of patients undergoing endoscopic endonasal surgery for pituitary macroadenomas assisted with a low-field iMRI (PoleStarN30, 0.15 T [Medtronic]).

[Stereoelectroencephalography by using O-Arm and Vertek passive articulated arm: Technical note and experience of an epilepsy referral centre].

Objective: To report a novel, accurate, and safe technique for deep brain electrode implantation to register brain electrical activity or SEEG, using frameless stereotaxy, neuronavigation assisted, and intraoperative CT-guided O-Arm and the Vertek articulated passive arm.

Material And Methods: All patients implanted by this technique in Barcelona Hospital Clinic were included. A prospective evaluation was made of the accuracy of the technique, as well as complications, surgical time, length of stay, and short-term outcomes.

[Low field intra-operative magnetic resonance imaging for brain tumour surgery: preliminary experience].

Objectives: Intra-operative magnetic resonance imaging (iMRI) is a recently introduced tool in the most advanced neurosurgical operating rooms worldwide. We present our preliminary experience in brain tumour surgery with low field PoleStar N30® intraoperative MRI since its introduction in 2013 in the Barcelona Clinic Hospital.

Material And Methods: A prospective non-randomised study was conducted on cases operated on using iMRI and intention of complete removal up to October 2015.

[Endoscopic endonasal surgery for sellar region pathology. An analysis of our first 200 patients. What we have learned].

Introduction: Pituitary and sellar region tumours account for 10-15% of intracranial benign tumours, with pituitary adenoma being the most common one. In this article, a review is presented on 9 years of experience in surgical treatment using an endoscopic approach of sellar region lesions. The main features of our surgical technique will be explained, as well as the results in clinical and hormonal terms.

Endoscopic endonasal surgery for pituitary tumors. Results in a series of 121 patients operated at the same center and by the same neurosurgeon.

Introduction: Pituitary adenomas account for approximately 15% of intracranial benign tumors. The neurosurgical results achieved since the endoscopic endonasal transsphenoidal (EET) approach was introduced in our center in 2005 are reported here.

Patients And Methods: A retrospective analysis of 121 patients with sellar lesions (58% females, age 55.