Summary
Background. Histopathological diagnosis of intraorbital tumours is of crucial value for planning further therapy. The aim of the study was to explore clinical utility of image-guided endoscopy for biopsy of orbital tumours.
Method. Trans-nasal endoscopic biopsy of intraorbital mass lesions was performed in 6 patients using a neuro-navigation system (Medtronic Stealth Station Treon plus). The CT and MRI 1 mm slice images were fused by the system in order to visualise both bony and soft tissue structures. The anatomic fiducial registration protocol was used during the procedure.
Results. All lesions were precisely localised and the biopsies could be taken from the representative part of the pathological mass. None of the patients developed aggravation of ocular symptoms after the procedure. The operative corridor as well as the size of orbital wall fenestration could be limited to a minimum. The accuracy of neuro-navigation remained high and stable during the entire procedure.
Conclusions. The image-guided neuro-navigation system facilitated endoscopic localisation and biopsy of intraorbital tumours and contributed to the reduction of surgical trauma during the procedure. The technique was particularly useful in small, medially located, retrobulbar tumours and in unclear situations when the structure of the lesion resembled surrounding intraorbital tissue.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
R Eliashar JY Sichel M Gross E Hockwald I Dano A Biron A Ben-Yaakov A Goldfarb J Elidan (2003) ArticleTitleImage guided navigation system – a new technology for complex endoscopic endonasal surgery Postgrad Med J 79 686–690 Occurrence Handle14707243 Occurrence Handle1:STN:280:DC%2BD2c%2FhtVKksg%3D%3D
W Freysinger AR Gunkel WF Thumfart (1997) ArticleTitleImage-guided endoscopic ENT surgery Eur Arch Otorhinolaryngol 254 343–346 Occurrence Handle9298670 Occurrence Handle10.1007/BF02630726 Occurrence Handle1:STN:280:ByiH2czpvF0%3D
N Hejazi (2006) ArticleTitleFrameless image-guided neuro-navigation in orbital surgery: practical applications Neurosurg Rev 29 118–122 Occurrence Handle16374647 Occurrence Handle10.1007/s10143-005-0007-3
P Herman G Lot B Silhouette R Marianowski F Portier M Wassef PT Huy (1999) ArticleTitleTrans-nasal endoscopic removal of an orbital cavernoma Ann Otol Rhinol Laryngol 108 147–150 Occurrence Handle10030232 Occurrence Handle1:STN:280:DyaK1M7ltlejsQ%3D%3D
M Karaki R Kobayashi N Mori (2006) ArticleTitleRemoval of an orbital apex haemangioma using an endoscopic trans-ethmoidal approach: technical note Neurosurgery 59 159–160 Occurrence Handle10.1227/01.NEU.0000220027.49155.80
TT Kingdom JM Delgaudio (2003) ArticleTitleEndoscopic approach to lesions of the sphenoid sinus, orbital apex, and clivus Am J Otolaryngol 24 317–322 Occurrence Handle13130444 Occurrence Handle10.1016/S0196-0709(03)00062-0
W Koele H Stammberger A Lackner P Reittner (2002) ArticleTitleImage guided surgery of paranasal sinuses and anterior skull base – five years experience with the Insta Trak-System Rhinology 40 1–9 Occurrence Handle12012946
R Metson M Cosenza RE Gliklich WW Montgomery (1999) ArticleTitleThe role of image-guidance systems for head and neck surgery Arch Otolaryngol Head Neck Surg 125 1100–1104 Occurrence Handle10522501 Occurrence Handle1:STN:280:DyaK1MvltVegtA%3D%3D
O Michel (2000) ArticleTitleTrans-nasal surgery of the orbita. Review of current indications and techniques HNO 48 4–17 Occurrence Handle10663043 Occurrence Handle10.1007/s001060050002 Occurrence Handle1:STN:280:DC%2BD3c7jtVSrsw%3D%3D
DL Monin K Blumner NA Cohen JS Brooks C Chen DW Kennedy (2005) ArticleTitleEndoscopic resection of a venous haemangioma of the optic nerve sheath Ear Nose Throat J 84 586 Occurrence Handle16261759
A Tsirbas M Kazim L Close (2005) ArticleTitleEndoscopic approach to orbital apex lesions Ophthal Plast Reconstr Surg 21 271–275 Occurrence Handle16052139 Occurrence Handle10.1097/01.iop.0000169254.44642.3d
DS Sethi DP Lau (1997) ArticleTitleEndoscopic management of orbital apex lesions Am J Rhinol 11 449–455 Occurrence Handle9438058 Occurrence Handle10.2500/105065897780914884 Occurrence Handle1:STN:280:DyaK1c7gtVyksg%3D%3D
AM Stamm (2006) ArticleTitleTrans-nasal endoscopy-assisted skull base surgery Ann Otol Rhinol Laryngol Suppl 196 45–53 Occurrence Handle17040018
SK Wise JM DelGaudio (2005) ArticleTitleComputer-aided surgery of the paranasal sinuses and skull base Expert Rev Med Devices 2 395–408 Occurrence Handle16293079 Occurrence Handle10.1586/17434440.2.4.395
Author information
Authors and Affiliations
Corresponding author
Additional information
Correspondence: Andrzej Sieskiewicz, MD, PhD, Department of Otolaryngology, Head and Neck Surgery, Medical University of Bialystok, ul. Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland.
Rights and permissions
About this article
Cite this article
Sieskiewicz, A., Lyson, T., Mariak, Z. et al. Endoscopic trans-nasal approach for biopsy of orbital tumours using image-guided neuro-navigation system. Acta Neurochir (Wien) 150, 441–445 (2008). https://doi.org/10.1007/s00701-008-1558-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-008-1558-1