Endoscopic Transglabellar & Supraorbital approach

25-5-20168.48 pm

Great teachers – All this is their work . I am just the reader of their books .

Prof. Paolo castelnuovo

Prof. Aldo Stamm Prof. Mario Sanna

Prof. Magnan

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Endoscopic Transglabellar approach

It seems there is no need of pituitary transposition with this approach – refer books & paper - http://www.ncbi.nlm.nih.gov/pubmed/11314063

Large macroadenomas with supra- or parasellar extension that is beyond the limits of the endonasal approach should undergo a second-stage endoscopic supraorbital or transglabellar approach.- Shahinian

In contrast, craniopharyngiomas within the pre-chiasmatic

space can be removed via a supraorbital or endonasal route, while tumors with lateral extensions or supra-chiasmatic extensions can be most effectively removed by a supra-

orbital or lateral transcranial approach. – from craniopharyngioma book

http://www.skullbaseinstitute.com/craniopharyngioma/ - Dr. Shahanian

Occasionally, craniopharyngiomas extend laterally beyond the midline. Craniopharyngiomas that extend laterally are approached through the most recent technical innovation at the Skull Base Institute, this fully endoscopic approach involves placing an incision within the hair of the eyebrow, performing a 1-1.5cm keyhole supraorbital opening and advancing the endoscope along the floor of the anterior cranial fossa underneath the frontal lobe. This approach allows a panoramic visualization of the ipsilateral anterior fossa and a partial visualization of the contralateral anterior fossa.

Although most craniopharyngiomas are completely resected through one of these minimally invasive approaches, occasionally giant lesions may require a combination of the endoscopic transnasal approach with either the endoscopic frontal approach or the endoscopic supraorbital approach. This can either be done simultaneously or can be staged as two separate procedures. This allows a complete and total resection of virtually most craniopharyngiomas from small completely intrasellar lesions all the way to giant craniopharyngiomas extending to the suprasellar area and also spilling laterally into the base of the anterior or middle cranial fossae.

Endoscopic Supraorbital approach

Suprasellar anterior meningioma removal by endoscopic supra-orbital approach

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