Acta Neurochirurgica

, Volume 160, Issue 8, pp 1583–1584 | Cite as

Endoscopic transpalpebral transorbital anterior petrosectomy: does “safer surgical freedoms” necessitates modifications?

  • Alhusain NagmEmail author
  • Tetsuya Goto
  • Toshihiro Ogiwara
  • Tetsuyoshi Horiuchi
  • Kazuhiro Hongo
Letter to the Editor - Neurosurgical Anatomy
Part of the following topical collections:
  1. Neurosurgical anatomy

Dear Editor:

We have read with great consideration the paper “Endoscopic transorbital route to the petrous apex: a feasibility anatomic study,” by Professor Paolo Cappabianca and colleagues [3]. The authors [3] presented an excellent qualitative stepwise endoscopic transpalpebral transorbital route to the petrous apex with adequate petrous apicectomy. Additionally, they were able to delineate three anatomic spaces (cerebellopontine angle, middle tentorial incisura, and ventral brainstem) and they analyzed the limitations of their technique [3].

As our lead author (A.N.) is involved in the endoscopic transorbital anatomical studies and collecting novel data [4], he would like to ask the authors [3] about specific surgical nuances that might allow surgeons to create an ideal surgical space with safer exposure and good maneuverability that evolved from combinations of pearls from multiple approaches [1, 2, 3, 4, 5] while avoiding major drawbacks.

Based on our lead author’s (A.N.)...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Almeida JP, Omay SB, Shetty SR, Chen YN, Ruiz-Treviño AS, Liang B, Anand VK, Levine B, Schwartz TH (2017) Transorbital endoscopic eyelid approach for resection of sphenoorbital meningiomas with predominant hyperostosis: report of 2 cases. J Neurosurg doi:
  2. 2.
    Almeida JP, Ruiz-Treviño AS, Shetty SR, Omay SB, Anand VK, Schwartz TH (2017) Transorbital endoscopic approach for exposure of the sylvian fissure, middle cerebral artery and crural cistern: an anatomical study. Acta Neurochir doi:
  3. 3.
    Di Somma A, Andaluz N, Cavallo LM, Topczewski TE, Frio F, Gerardi RM, Pineda J, Solari D, Enseñat J, Prats-Galino A, Cappabianca P (2018) Endoscopic transorbital route to the petrous apex: a feasibility anatomic study. Acta Neurochir 160(4):707–720CrossRefPubMedGoogle Scholar
  4. 4.
    Nagm A, Ogiwara T, Goto T, Hongo K, Ohata K (2018) Letter to the Editor. Collecting data about the transorbital endoscopic eyelid approach. J Neurosurg 1–2. doi:
  5. 5.
    Noiphithak R, Yanez-Siller JC, Revuelta Barbero JM, Otto BA, Carrau RL, Prevedello DM (2018) Comparative analysis between lateral orbital rim preservation and osteotomy for transorbital endoscopic approaches to the cavernous sinus: an anatomic study. Oper Neurosurg (Hagerstown) 2018. doi:

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryShinshu University School of MedicineMatsumotoJapan
  2. 2.Department of NeurosurgeryAl-Azhar University Faculty of Medicine-Nasr cityCairoEgypt

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