Transorbital neuroendoscopic surgery for the treatment of skull base lesions

In this study, we aimed to retrospectively review the largest experience to our knowledge with regards to surgical outcomes of skull base pathologies treated with a TONES procedure. Forty patients (aged 3–89years) underwent 45 TONES procedures between the years of 2006–2013. Pathologies were cerebrospinal fluid leak repair (n=16), traumatic fracture (n=8), tumor (n=11), meningoencephalocele (n=5), hematoma (n=1), and infection (n=4). Three patients had a persistent complication at 3months, including a case each of enophthalmos (unnoticed by patient), epiphora (delayed presentation at 2months requiring dacryocystorhinostomy), and ptosis (improved at 1year). Surgical success was achieved in all patients. Of special import, there were no cases of visual decline, diplopia, or stroke. There was no mortality. To our knowledge this is the first study and largest experience of TONES (level 4 evidence) to detail outcomes with respect to skull base pathologies. Our results indicate that TONES procedures can be performed with minimal morbidity. Further studies are needed to assess equivalency with craniotomy based approaches though this initial report is encouraging.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research