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J Neurol Surg B Skull Base
DOI: 10.1055/a-2561-7751
Original Article

Endoscopic Transorbital Approach for Select Recurrent and Newly Diagnosed Anteromedial Temporal Lobe Gliomas

Jonathan A. Tangsrivimol 
1   Department of Neurosurgery, Chulabhorn Hospital, Bangkok, Thailand
2   Department of Neurological Surgery, New York-Presbyterian Weill Cornell Medical Center, New York, New York, United States
,
Nader Delavari
2   Department of Neurological Surgery, New York-Presbyterian Weill Cornell Medical Center, New York, New York, United States
,
Kyle J. Godfrey
3   Department of Ophthalmology, NewYork-Presbyterian Weill Cornell Medical Center, New York, New York, United States
,
Theodore H. Schwartz
4   New York, New York, United States
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Abstract

Background and Objective

The endoscopic lateral transorbital approach (eLTOA) has emerged as a minimal access technique for accessing the middle fossa and periorbital region. This study explores the applicability of eLTOA in the management of recurrent and newly diagnosed medial temporal lobe gliomas.

Methods

Forty patients at our institution underwent eLTOA between 2016 and 2024. There were five surgeries for glioma. Patients were assessed for demographic and clinical data, radiographic characteristics, and histopathological and molecular findings.

Results

Four recurrent gliomas required biopsy for diagnosis and molecular genotyping, and one newly diagnosed tumor aimed for gross total resection (GTR). Histologic diagnoses remained unchanged in three recurrent cases (two glioblastoma multiforme and one xanthoastrocytoma). One case was upgraded from oligoastrocytoma Grade II to glioblastoma Grade IV. GTR was achieved in the newly diagnosed tumor, with histology confirming dysembryoplastic neuroepithelial tumor. Average length of stay was 3 days. There was one case of transient diplopia.

Conclusion

eLTOA offers a minimally invasive, direct approach to medial temporal lobe gliomas that minimizes the risks of infection and temporalis muscle atrophy associated with reoperation through a previously irradiated incision. It is most useful for restaging recurrent tumors, although GTR can be obtained in well-selected newly diagnosed tumors.

Keywords

glioma - transorbital - endoscopic - temporal lobe - low grade - high grade


Publikationsverlauf

Eingereicht: 06. Januar 2025

Angenommen: 14. März 2025

Accepted Manuscript online:
21. März 2025

Artikel online veröffentlicht:
09. April 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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