Peto, Ivo ORCID: 0000-0002-6015-6862, Molcanyi, Marek, Noureldine, Mohammad Hassan A., Bajric, Jasmina and Agazzi, Siviero . Transpalpebral transorbital neuroendoscopic (TONES) repair of orbital meningoencephalocele: a technical note. Br. J. Neurosurg.. ABINGDON: TAYLOR & FRANCIS LTD. ISSN 1360-046X

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Abstract

Purpose Intraorbital encephalocele (OMEC) is a rare entity in adults, usually secondary to an orbital pathology or prior trauma, in particular orbital roof fractures. Treatment of the OMEC is warranted to alleviate the pulsating exophthalmos and prevent potential visual decline. OMEC and orbital roof fractures have been predominantly treated via a craniotomy with a reconstruction of the orbital roof using various implants. With the advances in the endoscopic techniques, neuroendoscopy found its application in the treatment of orbital pathologies. We report a minimally invasive alternative: endoscopic transorbital repair of OMEC. Material and methods The repair technique is described with illustrations and clinical images. Narrated operative video demonstrating the procedure is provided. Results Illustrative case: 50-year-old female presented with progressive right eye proptosis over 6 months. Computed tomography (CT) demonstrated bony erosion in the lateral orbital roof, and magnetic resonance imaging (MRI) showed a small hyperintense T2-weighted and T1-weighted contrast enhancing lesion in the orbit, in the area of the bony erosion. Intraoperatively, the lesion was found to be an orbital encephalocele. The orbital defect was successfully repaired by employing the 'sandwich' technique, in which a dural substitute reinforced with tissue glue were deployed without repair of the osseous orbital roof. The patient tolerated the procedure well with ultimate resolution of proptosis. The cosmetic outcome was excellent. Conclusion The transorbital neuroendoscopic approach (TONES) presents a feasible, minimally invasive alternative treatment option for circumscribed intraorbital encephaloceles with minimal side effects, well tolerated by patients.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Peto, IvoUNSPECIFIEDorcid.org/0000-0002-6015-6862UNSPECIFIED
Molcanyi, MarekUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Noureldine, Mohammad Hassan A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bajric, JasminaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Agazzi, SivieroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-581763
DOI: 10.1080/02688697.2021.1888873
Journal or Publication Title: Br. J. Neurosurg.
Publisher: TAYLOR & FRANCIS LTD
Place of Publication: ABINGDON
ISSN: 1360-046X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Clinical Neurology; SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/58176

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