Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation

Background and objective: Various surgical routes have been used to decompress the intracanalicular optic nerve. Historically, a transcranial corridor was used, but more recently, ventral approaches (endonasal and/or transorbital) have been proposed, individually or in combination. The present study...

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Autores: Di Somma, Alberto, Andaluz, Norberto, Gogela, Steven, Cavallo, Luigi Maria, Keller, Jeffrey T., Prats Galino, Alberto, Cappabianca, Paolo
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2017
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/161420
Acceso en línea:https://hdl.handle.net/2445/161420
Access Level:acceso abierto
Palabra clave:Cirurgia cranial
Nervi òptic
Skull surgery
Optic nerve
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spelling Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory InvestigationDi Somma, AlbertoAndaluz, NorbertoGogela, StevenCavallo, Luigi MariaKeller, Jeffrey T.Prats Galino, AlbertoCappabianca, PaoloCirurgia cranialNervi òpticSkull surgeryOptic nerveBackground and objective: Various surgical routes have been used to decompress the intracanalicular optic nerve. Historically, a transcranial corridor was used, but more recently, ventral approaches (endonasal and/or transorbital) have been proposed, individually or in combination. The present study aims to detail and quantify the amount of bony optic canal removal that may be achieved via transcranial, transorbital, and endonasal pathways. In addition, the surgical freedom of each approach was analyzed. Methods: In 10 cadaveric specimens (20 canals), optic canals were decompressed via pterional, endoscopic endonasal, and endoscopic superior eyelid transorbital corridors. The surgical freedom and circumferential optic canal decompression afforded by each approach was quantitatively analyzed. Statistical comparison was carried using a nonpaired Student t test. Results: An open pterional transcranial approach allowed the greatest area of surgical freedom (transcranial, 109.4 ± 33.6 cm2; transorbital, 37.2 ± 4.9 cm2; endonasal homolateral, 10.9 ± 5.2 cm2; and endonasal contralateral, 11.1 ± 5.6 cm2) with widest optic canal decompression compared with the other 2 ventral routes (transcranial, 245.2; transorbital, 177.9; endonasal, 144.6). These differences reached, in many cases, statistical significance for the transcranial approach. Conclusions: This anatomic contribution provides a comprehensive evaluation of surgical access to the optic canal via 3 distinct, but complementary, approaches: transcranial, transorbital, and endonasal. Our results show that, as expected, a transcranial approach achieved the widest degree of circumferential optic canal decompression and the greatest surgical freedom for manipulation of surgical instruments. Further surgical experience is necessary to determine the proper surgical indication for the transorbital approach to this disease.Elsevier2020202020172020info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersion30 p.application/pdfhttps://hdl.handle.net/2445/161420Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésVersió postprint del document publicat a: https://doi.org/10.1016/j.wneu.2017.01.117World Neurosurgery, 2017, vol. 101, p. 227 -235https://doi.org/10.1016/j.wneu.2017.01.117cc-by-nc-nd (c) Elsevier, 2017http://creativecommons.org/licenses/by-nc-nd/3.0/esinfo:eu-repo/semantics/openAccessoai:recercat.cat:2445/1614202026-05-29T05:05:01Z
dc.title.none.fl_str_mv Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation
title Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation
spellingShingle Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation
Di Somma, Alberto
Cirurgia cranial
Nervi òptic
Skull surgery
Optic nerve
title_short Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation
title_full Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation
title_fullStr Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation
title_full_unstemmed Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation
title_sort Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation
dc.creator.none.fl_str_mv Di Somma, Alberto
Andaluz, Norberto
Gogela, Steven
Cavallo, Luigi Maria
Keller, Jeffrey T.
Prats Galino, Alberto
Cappabianca, Paolo
author Di Somma, Alberto
author_facet Di Somma, Alberto
Andaluz, Norberto
Gogela, Steven
Cavallo, Luigi Maria
Keller, Jeffrey T.
Prats Galino, Alberto
Cappabianca, Paolo
author_role author
author2 Andaluz, Norberto
Gogela, Steven
Cavallo, Luigi Maria
Keller, Jeffrey T.
Prats Galino, Alberto
Cappabianca, Paolo
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Cirurgia cranial
Nervi òptic
Skull surgery
Optic nerve
topic Cirurgia cranial
Nervi òptic
Skull surgery
Optic nerve
description Background and objective: Various surgical routes have been used to decompress the intracanalicular optic nerve. Historically, a transcranial corridor was used, but more recently, ventral approaches (endonasal and/or transorbital) have been proposed, individually or in combination. The present study aims to detail and quantify the amount of bony optic canal removal that may be achieved via transcranial, transorbital, and endonasal pathways. In addition, the surgical freedom of each approach was analyzed. Methods: In 10 cadaveric specimens (20 canals), optic canals were decompressed via pterional, endoscopic endonasal, and endoscopic superior eyelid transorbital corridors. The surgical freedom and circumferential optic canal decompression afforded by each approach was quantitatively analyzed. Statistical comparison was carried using a nonpaired Student t test. Results: An open pterional transcranial approach allowed the greatest area of surgical freedom (transcranial, 109.4 ± 33.6 cm2; transorbital, 37.2 ± 4.9 cm2; endonasal homolateral, 10.9 ± 5.2 cm2; and endonasal contralateral, 11.1 ± 5.6 cm2) with widest optic canal decompression compared with the other 2 ventral routes (transcranial, 245.2; transorbital, 177.9; endonasal, 144.6). These differences reached, in many cases, statistical significance for the transcranial approach. Conclusions: This anatomic contribution provides a comprehensive evaluation of surgical access to the optic canal via 3 distinct, but complementary, approaches: transcranial, transorbital, and endonasal. Our results show that, as expected, a transcranial approach achieved the widest degree of circumferential optic canal decompression and the greatest surgical freedom for manipulation of surgical instruments. Further surgical experience is necessary to determine the proper surgical indication for the transorbital approach to this disease.
publishDate 2017
dc.date.none.fl_str_mv 2017
2020
2020
2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/161420
url https://hdl.handle.net/2445/161420
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1016/j.wneu.2017.01.117
World Neurosurgery, 2017, vol. 101, p. 227 -235
https://doi.org/10.1016/j.wneu.2017.01.117
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Elsevier, 2017
http://creativecommons.org/licenses/by-nc-nd/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Elsevier, 2017
http://creativecommons.org/licenses/by-nc-nd/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 30 p.
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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