Neurosurgical focus: Video最新文献

This surgical video demonstrates the case of a 38-year-old male with recurrent inverted papilloma involving the lamina papyracea and frontal sinus outflow tract. The frontal sinus was diminutive on the side of the tumor, and as such a combined endoscopic endonasal with endoscopic transorbital via transcaruncular route was advised for resection of the anterolateral tumor and contralateral margin. After endonasal resection, a transorbital approach was utilized to traverse the lamina papyracea from lateral to medial and resect tumor along the ethmoid roof and posterior table of the frontal sinus. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24201.

Anterior temporal lobectomy and selective amygdalohippocampectomy are standard treatments for refractory temporal lobe epilepsy. Yet, they carry risks of lateral temporal damage to both neocortical and white matter structures, including the optic radiations. This video details a case of endoscopic transorbital amygdalohippocampectomy performed to resect an epileptogenic lesion. This approach offers minimally invasive access to the medial temporal lobe along its longitudinal axis, while preserving the lateral temporal area. Postoperative MRI showed resection of most of the amygdala, including its superior portion, and the hippocampus up to the tectal plate. This minimally invasive technique provides a promising alternative to traditional open surgery. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24198.

Endoscopic transorbital approaches have been increasingly used to treat lesions of the middle fossa, such as sphenoid wing meningiomas or cavernous sinus disease, eschewing the cosmetic and functional consequences of a frontotemporal craniotomy, as well as technical shortcomings of endoscopic endonasal approaches. In this video, the authors present a case of a spheno-orbital meningioma for which an endoscopic transorbital approach was used for tumor resection, optic canal decompression, and anterior clinoidectomy. The advantages of this approach are demonstrated, particularly the direct, shorter distance to target along the axis of the middle fossa, which avoids neurovascular structures, brain retraction, and temporal muscle manipulation. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24199.

A 3-year-old male presented with a history of a nasal dermoid cyst with intracranial extension as well as a concomitant isolated intracranial dermoid cyst of the middle cranial fossa. Initially, at 2 years of age, he underwent successful transnasal endoscopic resection of an anterior skull base dermoid cyst. He then presented for a staged dermoid cyst resection of the right sphenoid bone at the lesser wing because of interval growth between imaging studies. A right-sided transorbital neuroendoscopic approach (TONES) was utilized for lesion resection. A gross-total resection was achieved, with no complications. Excellent neurological and cosmetic outcome was achieved. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24157.

Orbital cavernous hemangiomas are the most common benign primary neoplasm of the orbit in adults and can lead to proptosis and optic neuropathy. Resection is the primary treatment for symptomatic cases. Choice of surgical approach depends on the lesion's size, location, and relation to intraorbital structures. The authors present the case of a 40-year-old male with a large symptomatic orbital hemangioma resected through a combined endoscopic transorbital and endonasal approach. This case highlights the advantages of the combined approach, enhancing visibility and minimizing disruption of orbital structures, allowing for en bloc resection of large orbital hemangiomas. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24197.

Sphenoid wing meningiomas are slow-growing tumors arising in a region crossed by crucial neurovascular structures, for which surgery poses significant challenges. In the last decade, several cadaveric and clinical studies have proven the effectiveness of endoscopic transorbital surgery for skull base pathologies in accordance with the principles of minimal invasiveness. The ventral surgical corridor offered by this approach allows the early devascularization of the lesion without brain retraction, temporal muscle mobilization, and limited neurovascular structure manipulation. This 2D operative video describes the removal of a sphenoid wing meningioma using an endoscopic transorbital transpalpebral approach with minimal morbidity and quick recovery. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24179.

[This corrects the article DOI: 10.3171/2024.10.FOCVID24144.].

Endoscopic minimally invasive skull base surgery using the transorbital neuroendoscopic technique for cavernous sinus epidermoid serves as a pivotal link to open transcranial surgeries. This method involves a minimally invasive transorbital approach, including lateral orbitotomy and drilling the greater sphenoid wing, followed by cutting the orbitomeningeal band, peeling the dura mater, and exposing the tumor. This approach is technically demanding and requires thorough knowledge of anatomy and familiarity with endoscopic instruments. The favorable clinical, cosmetic, and radiological outcomes underscore the effectiveness of this technique, highlighting the role of endoscopy in minimally invasive skull base paramedian pathologies. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24188.

The authors present the case illustration of a 32-year-old female with worsening seizures with slight right orbital proptosis of unclear etiology. Imaging revealed a growing right temporal pole mass concerning for a glial tumor. The patient was an ideal candidate for transorbital endoscopic resection given its location and her epilepsy history. The mass was completely removed with the aid of electrocorticography (ECOG) to ensure no additional perilesional epileptic focus. The patient has had a 6-month follow-up with no worsening seizures and favorable cosmetic outcome. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24196.

Intraoperative neuropsychological testing (IONT) is a sophisticated method of cognitive mapping during the resection of brain tumors in eloquent areas. Direct electrical stimulation during awake craniotomy is routinely utilized for mapping basic language and sensorimotor function, but the utilization of IONT offers an individualized approach that can yield real-time, comprehensive feedback on various cognitive functions, allowing for a tailored and more extensive tumor resection. In this video, the authors present the case of a 41-year-old male undergoing re-resection for a recurrent right temporal astrocytoma in which IONT played a crucial role. The video can be found here: https://stream.cadmore.media/r10.3171/2024.10.FOCVID24128.