Endoscopic-assisted transorbital extended orbital exenteration: A multi-institutional preclinical study


Roccuzzo G., Vyskocil E., Hirtler L., Kandathil S. A., Peris-Celda M., Agosti E., ...Daha Fazla

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, cilt.46, sa.9, ss.2327-2339, 2024 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 46 Sayı: 9
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1002/hed.27858
  • Dergi Adı: HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.2327-2339
  • Anahtar Kelimeler: extended orbital exenteration, orbital apex dissection, orbital encroaching malignancies, preclinical cadaveric study, sinonasal malignant tumors
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

BackgroundSinonasal malignancies with orbital invasion have dismal prognosis even when treated with orbital exenteration (OE). Sugawara et al. developed a surgical strategy called "extended-OE (EOE)," showing encouraging outcomes. We hypothesized that a similar resection is achievable under endoscopic guidance through the exenterated orbit (endoscopic-EOE).MethodsThe study was conducted in three institutions: University of Vienna; Mayo Clinic; University of Insubria; 48 orbital dissections were performed. A questionnaire was developed to evaluate feasibility and safety of each step, scoring from 1 to 10, ("impossible" to "easy," and "high risk" to "low risk," respectively), most likely complication(s) were hypothesized.ResultsThe step-by-step technique is thoroughly described. The questionnaire was answered by 25 anterior skull base surgeons from six countries. Mean, median, range, and interquartile range of both feasibility and safety scores are reported.ConclusionsEndoscopic-EOE is a challenging but feasible procedure. Clinical validation is required to assess real-life outcomes.