Skip to main content

Advertisement

SpringerLink
Log in

Supraorbital subfrontal trans-laminar endoscope-assisted approach for tumors of the posterior third ventricle

  • Original Article _ Brain Tumors
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Different surgical approaches have been developed for dealing with third ventricle lesions, all aimed at obtaining a safe removal minimizing brain manipulation. The supraorbital subfrontal trans-lamina terminalis route, commonly employed only for the anterior third ventricle, could represent, in selected cases with endoscopic assistance, an alternative approach to posterior third ventricular lesions.

Methods

Seven patients underwent a supraorbital subfrontal trans-laminar endoscope-assisted approach to posterior third ventricle tumors (two craniopharyngiomas, one papillary tumor of the pineal region, one pineocytoma, two neurocytomas, one glioblastoma). Moreover, a conventional third ventriculostomy was performed via the same trans-laminar approach in four cases.

Results

Complete tumor removal was accomplished in four cases, subtotal removal in two cases, and a simple biopsy in one case. Adjuvant radiotherapy and/or chemotherapy was administered, if required, on the basis of the histologic diagnosis. No major complications occurred after surgery except for an intratumoral hemorrhage in a patient undergoing a biopsy for a glioblastoma, which simply delayed the beginning of adjuvant radiochemotherapy. No ventriculoperitoneal shunt placement was needed in these patients at the most recent clinical and radiologic session (average 39.57 months, range 13–85 months). Two illustrative cases are presented.

Conclusions

The supraorbital subfrontal trans-laminar endoscope-assisted approach may provide, in selected cases, an efficient and safe route for dealing with posterior third ventricular tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Abdou MS, Cohen AR (2000) Endoscopic surgery of the third ventricle: the subfrontal trans-lamina terminalis approach. Minim Invasive Neurosurg 43(4):208–211

    Article  CAS  PubMed  Google Scholar 

  2. Cavallo LM, Solari D, Esposito F, Villa A, Minniti G, Cappabianca P (2014) The role of the endoscopic endonasal route in the management of craniopharyngiomas. World Neurosurg 82(6 Suppl):S32–S40

    Article  PubMed  Google Scholar 

  3. Cavallo LM, Solari D, Esposito F, Cappabianca P (2013) The endoscopic endonasal approach for the management of craniopharyngiomas involving the third ventricle. Neurosurg Rev 36(1):27–37, discussion 38

    Article  PubMed  Google Scholar 

  4. Charalampaki P, Filippi R, Welschehold S, Conrad J, Perneczky A (2008) Tumors of the lateral and third ventricle: removal under endoscope-assisted keyhole conditions. Neurosurgery 62(6 Suppl 3):1049–1058

    PubMed  Google Scholar 

  5. Chibbaro S, Di Rocco F, Makiese O et al (2012) Neuroendoscopic management of posterior third ventricle and pineal region tumors: technique, limitation, and possible complication avoidance. Neurosurg Rev 35(3):331-338-340

  6. Colasanti R, Lamki T, Tailor A-RA, Ammirati M (2014) Recurrent atlantoaxial synovial cyst resection via a navigation-guided, endoscope-assisted posterior approach. Surg Neurol Int 5(Suppl 15):S567–S569

    PubMed  PubMed Central  Google Scholar 

  7. Colasanti R, Tailor A-RA, Gorjian M, Zhang J, Ammirati M (2015) Microsurgical and endoscopic anatomy of the extended retrosigmoid inframeatal infratemporal approach. Neurosurgery 11(Suppl 2):181–189, discussion 189

    PubMed  Google Scholar 

  8. Colasanti R, Tailor A-RA, Lamki T, Zhang J, Ammirati M (2015) Maximizing the petroclival region exposure via a suboccipital retrosigmoid approach: where is the intrapetrous internal carotid artery? Neurosurgery 11(Suppl 2):329-336-337

  9. Colasanti R, Tailor A-RA, Zhang J, Ammirati M (2016) Expanding the horizon of the suboccipital retrosigmoid approach to the middle incisural space by cutting the tentorium cerebelli: anatomic study and illustration of 2 cases. World Neurosurg 92:303–312

    Article  PubMed  Google Scholar 

  10. Colasanti R, Tailor A-RA, Zhang J, Ammirati M (2016) Functional petrosectomy via a suboccipital retrosigmoid approach: guidelines and topography. World Neurosurg 87:143–154

    Article  PubMed  Google Scholar 

  11. Dandy WE (1921) An operation for the removal of pineal tumors. Surg Gynecol Obstet 33:113–119

    Google Scholar 

  12. Dandy WE (1933) Benign tumors in the third ventricle of the brain: diagnosis and treatment. Charles C Thomas, Springfield

    Google Scholar 

  13. de Divitiis O, Angileri FF, d’Avella D, Tschabitscher M, Tomasello F (2002) Microsurgical anatomic features of the lamina terminalis. Neurosurgery 50(3):563-569-570

  14. Dehdashti AR, de Tribolet N (2008) Frontobasal interhemispheric trans-lamina terminalis approach for suprasellar lesions. Neurosurgery 62(6 Suppl 3):1233–1239

    PubMed  Google Scholar 

  15. Figueiredo EG, Deshmukh V, Nakaji P, Deshmukh P, Crusius MU, Crawford N, Spetzler RF, Preul MC (2006) An anatomical evaluation of the mini-supraorbital approach and comparison with standard craniotomies. Neurosurgery 59(4 Suppl 2):ONS212-220; discussion ONS220

  16. Iacoangeli M, Di Rienzo A, Colasanti R, et al. Endoscopic transnasal odontoidectomy with anterior C1 arch preservation and anterior vertebral column reconstruction in patients with irreducible bulbomedullary compression by complex craniovertebral junction abnormalities: operative nuance. Neurosurgery. doi:10.1227/NEU.0000000000001330

  17. Iacoangeli M, Di Rienzo A, di Somma LGM, Moriconi E, Alvaro L, Re M, Salvinelli F, Carassiti M, Scerrati M (2014) Improving the endoscopic endonasal transclival approach: the importance of a precise layer by layer reconstruction. Br J Neurosurg 28(2):241–246

    Article  PubMed  Google Scholar 

  18. Iacoangeli M, Di Rienzo A, Nocchi N, Balercia P, Lupi E, Regnicolo L, Di Somma LGM, Alvaro L, Scerrati M (2015) Piezosurgery as a further technical adjunct in minimally invasive supraorbital keyhole approach and lateral orbitotomy. J Neurol Surg A Cent Eur Neurosurg 76(2):112–118

    PubMed  Google Scholar 

  19. Iacoangeli M, Di Rienzo A, Re M, Alvaro L, Nocchi N, Gladi M, De Nicola M, Scerrati M (2013) Endoscopic endonasal approach for the treatment of a large clival giant cell tumor complicated by an intraoperative internal carotid artery rupture. Cancer Manag Res 5:21–24

    Article  PubMed  PubMed Central  Google Scholar 

  20. Iacoangeli M, Neri P, Balercia P, Lupi E, Di Rienzo A, Nocchi N, Alvaro L, Scerrati M (2013) Piezosurgery for osteotomies in orbital surgery: our experience and review of the literature. Int J Surg Case Rep 4(2):188–191

    Article  PubMed  Google Scholar 

  21. Iacoangeli M, Nocchi N, Nasi D, DI Rienzo A, Dobran M, Gladi M, Colasanti R, Alvaro L, Polonara G, Scerrati M (2016) Minimally invasive supraorbital key-hole approach for the treatment of anterior cranial fossa meningiomas. Neurol Med Chir (Tokyo) 56(4):180–185

    Article  Google Scholar 

  22. Iacoangeli M, Rienzo AD, Colasanti R, Scarpelli M, Gladi M, Alvaro L, Nocchi N, Scerrati M (2014) A rare case of chordoma and craniopharyngioma treated by an endoscopic endonasal, transtubercular transclival approach. Turk Neurosurg 24(1):86–89

    PubMed  Google Scholar 

  23. King TT (1979) Removal of intraventricular craniopharyngiomas through the lamina terminalis. Acta Neurochir (Wien) 45(3–4):277–286

    Article  CAS  Google Scholar 

  24. Krishna V, Blaker B, Kosnik L, Patel S, Vandergrift W (2011) Trans-lamina terminalis approach to third ventricle using supraorbital craniotomy: technique description and literature review for outcome comparison with anterior, lateral and trans-sphenoidal corridors. Minim Invasive Neurosurg 54(5–6):236–242

    CAS  PubMed  Google Scholar 

  25. Lan Q, Dong J, Huang Q (2006) Minimally invasive keyhole approaches for removal of tumors of the third ventricle. Chin Med J (Engl) 119(17):1444–1450

    Google Scholar 

  26. Nishioka H, Fukuhara N, Yamaguchi-Okada M, Yamada S (2016) Endoscopic endonasal surgery for purely intra-third ventricle craniopharyngioma. World Neurosurg. doi:10.1016/j.wneu.2016.04.042

    PubMed  Google Scholar 

  27. Reisch R, Perneczky A (2005) Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision. Neurosurgery 57(4 Suppl):242-255-255

  28. Rhoton AL (2002) The lateral and third ventricles. Neurosurgery 51(4 Suppl):S207–S271

    PubMed  Google Scholar 

  29. Salma A, Ammirati M (2012) Real time parallel intraoperative integration of endoscopic, microscopic, and navigation images: a proof of concept based on laboratory dissections. J Neurol Surg B Skull Base 73(1):36–41

    Article  PubMed  PubMed Central  Google Scholar 

  30. Silva PS, Cerejo A, Polónia P, Pereira J, Vaz R (2013) Trans-lamina terminalis approach for third ventricle and suprasellar tumours. Clin Neurol Neurosurg 115(9):1745–1752

    Article  PubMed  Google Scholar 

  31. Spena G, Fasel J, de Tribolet N, Radovanovic I (2008) Subfrontal endoscopic fenestration of lamina terminalis: an anatomical study. Minim Invasive Neurosurg 51(6):319–323

    Article  CAS  PubMed  Google Scholar 

  32. Yaşargil MG, Abdulrauf SI (2008) Surgery of intraventricular tumors. Neurosurgery 62(6 Suppl 3):1029-1040-1041

Download references

Author information

Author notes

    Authors and Affiliations

    1. Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Via Conca #71, Ancona, 60020, Italy

      Maurizio Iacoangeli, Roberto Colasanti, Domenic Esposito, Alessandro Di Rienzo, Lucia di Somma, Mauro Dobran, Maurizio Gladi & Massimo Scerrati

    Authors
    1. Maurizio Iacoangeli
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Roberto Colasanti
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Domenic Esposito
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Alessandro Di Rienzo
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Lucia di Somma
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Mauro Dobran
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Maurizio Gladi
      View author publications

      You can also search for this author in PubMed Google Scholar

    8. Massimo Scerrati
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Roberto Colasanti.

    Ethics declarations

    Funding

    No funding was received for this research.

    Conflict of interest

    None.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

    For this type of study formal consent is not required.

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

    Additional information

    Maurizio Iacoangeli and Roberto Colasanti contributed equally to this work.

    Electronic supplementary material

    Below is the link to the electronic supplementary material.

    Supplemental Digital Content

    Video illustrating the removal of a posterior third ventricle lesion by the supraorbital subfrontal trans-laminar endoscope-assisted approach. (WMV 34095 kb)

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Iacoangeli, M., Colasanti, R., Esposito, D. et al. Supraorbital subfrontal trans-laminar endoscope-assisted approach for tumors of the posterior third ventricle. Acta Neurochir 159, 645–654 (2017). https://doi.org/10.1007/s00701-017-3117-0

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00701-017-3117-0

    Keywords

    Search

    Navigation