Robotic arm vs. stereotactic frame in deep brain stimulation surgery for movement disorders: a retrospective cohort study.

Background: Recently, robotic arms have been incorporated into the implantation of electrodes for deep brain stimulation (DBS).This study aimed to determine the accuracy of brain electrode placement, initial clinical efficacy, and safety profile of the robotic arm Neuromate (Renishaw) compared to a stereotactic frame in movement disorders.

Methods: This study involved two retrospective cohorts: one cohort was operated on using a stereotactic frame and the other with a robotic arm.

Supraorbital, Transorbital, and Endonasal Approaches to the Supraoptic Recess: A Comparative, Qualitative, and Quantitative Anatomic Study.

Background And Objectives: The supraoptic recess is a bony pyramid-shape area with a base that abuts the sphenoid sinus and an apex that corresponds intracranially to the anterior clinoid process and the body of the lesser sphenoid wing. During an extended endoscopic endonasal approach, the recess needs to be identified and delineated to achieve further lateral extension over the planum sphenoidale. By drilling the supraoptic recess in a medial-to-lateral direction toward the body of the lesser sphenoid wing, the most medial portion of the lesser wing overlying the orbit could be exposed and progressively drilled out.

Microsurgical and endovascular treatment of large and giant aneurysms of the anterior circulation: A systematic review.

Introduction: Large and Giant intracranial aneurysms (LGIAs) have become the paradigm for which endovascular techniques do not provide satisfactory results. Yet, microsurgery is followed by non-negligible rates of morbimortality. This scenario may have changed since the introduction of flow-diversion devices.

Transorbital Route to Intracranial Space.

The endoscopic superior eyelid transorbital approach has emerged as a notable and increasingly utilized surgical technique in recent years. This chapter presents an overview of the approach, tracing its historical development and highlighting its growing acceptance within the skull base community.Beginning with an introduction and historical perspective, the chapter outlines the evolution of the transorbital approach, shedding light on its origins and the factors driving its adoption.

Endoscopic transorbital approach to the petrous apex: is orbital rim removal worthwhile for the exposure? An anatomical study with illustrative case.

Objective: The endoscopic transorbital approach (ETOA) has been demonstrated to be a feasible ventral route to the petrous apex. Yet, it has been pointed to as a deep and narrow corridor for anterior petrosectomy; particularly, medialization of the instruments can become an issue when targeting the petroclival area. To overcome this limitation, an ETOA with orbital rim removal (ETOA-OR) has been suggested, but not de facto compared, with a transorbital approach without removal of the rim.

Transorbital approach to the cavernous sinus: an anatomical study of the related cranial nerves.

Background: The cavernous sinus (CS) is a demanding surgical territory, given its deep location and the involvement of multiple neurovascular structures. Subjected to recurrent discussion on the optimal surgical access, the endoscopic transorbital approach has been recently proposed as a feasible route for selected lesions in the lateral CS. Still, for this technique to safely evolve and consolidate, a comprehensive anatomical description of involved cranial nerves, dural ligaments, and arterial relations is needed.

Neurophysiologic Monitoring of Oculomotor Nerves During Transorbital Surgery: Proof of Concept and Anatomic Demonstration.

Background And Objectives: Transorbital neuroendoscopic surgery (TONES) is continuously evolving and gaining terrain in approaching different skull base pathologies. The objective of this study was to present our methodology for introducing recording electrodes, which includes a new transconjunctival pathway, to monitor the extraocular muscle function during TONES.

Methods: A translational observational study was performed from an anatomic demonstration focused on the transconjunctival electrode placement technique to a descriptive analysis in our series of 6 patients operated using TONES in association with intraoperative neurophysiologic monitoring of the oculomotor nerves from 2017 to 2023.

Endoscopic transorbital approach bone pillars: a comprehensive stepwise anatomical appraisal.

Objective: The endoscopic superior eyelid transorbital approach has garnered significant consideration and gained popularity in recent years. Detailed anatomical knowledge along with clinical experience has allowed refinement of the technique as well as expansion of its indications. Using bone as a consistent reference, the authors identified five main bone pillars that offer access to the different intracranial targeted areas for different pathologies of the skull base, with the aim of enhancing the understanding of the intracranial areas accessible through this corridor.