{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:39:00Z","timestamp":1789231140761,"version":"build-2803163510"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n               Introduction\u2003Common approaches to remove skull base tumors invading the orbital apex, cavernous sinus, middle fossa, or temporal lobe include orbitozygomatic or fronto-orbital craniotomies. Recently, different types of orbital approaches have been described as alternative minimally invasive techniques.<\/jats:p><jats:p>\n               Objective\u2003With this systematic review, we analyzed the typology of intracranial tumors treated through transorbital approaches, especially through the lateral orbital (LO) wall, and analyzing the complication rates and outcomes.<\/jats:p><jats:p>\n               Design\u2003A PubMed\/Medline search was performed using the criteria: \u201corbitotomy,\u201d \u201ctransorbital,\u201d \u201ctranspalpebral,\u201d and \u201clateral orbitotomy\u201d in combination with \u201ccavernous sinus,\u201d \u201cmiddle fossa,\u201d and \u201ctemporal lobe.\u201d<\/jats:p><jats:p>\n               Main Outcome Measures\u2003From these reports, we collected diagnoses, lesion sizes and locations, approaches, outcomes, aesthetic outcomes, postoperative ptosis, postoperative cranial nerve (CN) palsies, length of CN deficits postoperatively, overall complications, and follow-up length.<\/jats:p><jats:p>\n               Results\u2003A total of 13 papers and 3 of our own cases matched our inclusion criteria totaling 160 patients. Most patients were treated for meningiomas (135, 84.4%). The approaches included the LO approach (n\u2009=\u200954; 33.8%), deep transorbital (n\u2009=\u20095; 3.1%), mini-LO (n\u2009=\u200991; 56.9%), and modified LO (n\u2009=\u200910; 6.2%). While not all cases reported excision success, the various LO approaches achieved total (n\u2009=\u200942; 26.25%) resection margins. Postoperative ocular complications (including CN palsies, proptosis, or ocular disturbances) totaled 46 (28.8%) new CN palsies, 23 (14.4%) occurrences of vision loss, 1 (1.7%) with worsened proptosis, 5 (3.9%) with worsened enophthalmos, and 42 (26.3%) other complications.<\/jats:p><jats:p>\n               Conclusion\u2003Microsurgical LO approaches, especially in the era of radiosurgery, may become a suitable alternative to other more established craniotomies.<\/jats:p>","DOI":"10.1055\/s-0044-1788645","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T23:06:22Z","timestamp":1722467182000},"page":"457-470","source":"Crossref","is-referenced-by-count":2,"title":["Microsurgical Lateral Orbital Approaches to Resect Tumors within the Cavernous Sinus, Middle Fossa, and Temporal Lobe: A Systematic Review"],"prefix":"10.1055","volume":"86","author":[{"given":"Molly","family":"Monsour","sequence":"additional","affiliation":[{"name":"University of South Florida Morsani College of Medicine, Tampa, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Rizk","sequence":"additional","affiliation":[{"name":"University of South Florida Morsani College of Medicine, Tampa, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Kazelka","sequence":"additional","affiliation":[{"name":"University of South Florida Morsani College of Medicine, Tampa, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Peto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Tai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siviero","family":"Agazzi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide M.","family":"Croci","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, United States"},{"name":"Department of Neurosurgery, Lakeland Regional Health, Lakeland, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fsurg.2020.00001","article-title":"Cranio-orbital and orbitocranial approaches to orbital and intracranial disease: eye-opening approaches for neurosurgeons","volume":"7","author":"H Abou-Al-Shaar","year":"2020","journal-title":"Front Surg"},{"key":"ref2","first-page":"ons195","article-title":"Minimally invasive transpalpebral \u201ceyelid\u201d approach to the anterior cranial base","volume":"69","author":"K M Abdel Aziz","year":"2011","journal-title":"Neurosurgery"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"730","DOI":"10.3171\/2014.4.JNS13787","article-title":"Patients' cosmetic satisfaction, pain, and functional outcomes after supraorbital craniotomy through an eyebrow incision","volume":"121","author":"R Reisch","year":"2014","journal-title":"J Neurosurg"},{"key":"ref4","first-page":"149","article-title":"Zur Pathologie und Behandlung der Dermoidcysten der Orbita","volume":"4","author":"R Kronlein","year":"1888","journal-title":"Beitr Klin Chir"},{"issue":"04","key":"ref5","first-page":"185","article-title":"Removal of tumours of the orbital apex via a postero-lateral orbitotomy","volume":"42","author":"F Carta","year":"1998","journal-title":"J Neurosurg Sci"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/00002341-199809000-00006","article-title":"Deep transorbital approach to the apex and cavernous sinus","volume":"14","author":"R A Goldberg","year":"1998","journal-title":"Ophthal Plast Reconstr Surg"},{"key":"ref7","volume-title":"Atlas of Orbital Tumors","author":"J SC Shields","year":"1999"},{"issue":"11","key":"ref9","doi-asserted-by":"crossref","first-page":"2135","DOI":"10.1007\/s00701-016-2940-z","article-title":"Surgical anatomy of the cavernous sinus, superior orbital fissure, and orbital apex via a lateral orbitotomy approach: a cadaveric anatomical study","volume":"158","author":"M Ulutas","year":"2016","journal-title":"Acta Neurochir (Wien)"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1093\/neuros\/nyw045","article-title":"Lateral orbitotomy approach for lesions involving the middle fossa: a retrospective review of thirteen patients","volume":"80","author":"J D Chabot","year":"2017","journal-title":"Neurosurgery"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4103\/2152-7806.157074","article-title":"Lateral orbitotomy approach for removing hyperostosing en plaque sphenoid wing meningiomas. Description of surgical strategy and analysis of findings in a series of 88 patients with long-term follow up","volume":"6","author":"A Amirjamshidi","year":"2015","journal-title":"Surg Neurol Int"},{"key":"ref12","first-page":"287","article-title":"Lateral orbitotomy for removal of sphenoid wing meningiomas invading the orbit","volume":"66","author":"G Mariniello","year":"2010","journal-title":"Neurosurgery"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1093\/ons\/opy199","article-title":"A modified lateral orbitotomy approach to the superior orbital fissure: a video case report and review of anatomy","volume":"16","author":"G A Alzhrani","year":"2019","journal-title":"Oper Neurosurg (Hagerstown)"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"343","DOI":"10.3109\/01676830.2014.904374","article-title":"Transorbital approach without craniotomy to orbital tumors with extradural intracranial extension","volume":"33","author":"H Lew","year":"2014","journal-title":"Orbit"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1227\/ons.0000000000000610","article-title":"Modified lateral orbitotomy approach to lesions of the orbital apex, superior orbital fissure, cavernous sinus, and middle cranial fossa","volume":"24","author":"M T Bounajem","year":"2023","journal-title":"Oper Neurosurg (Hagerstown)"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1055\/s-2008-1077077","article-title":"Spheno-orbital meningiomas: surgical approaches and outcome according to the intraorbital tumor extent","volume":"69","author":"G Mariniello","year":"2008","journal-title":"Zentralbl Neurochir"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"755","DOI":"10.3171\/2011.12.JNS111251","article-title":"Lateral orbital wall approach to the cavernous sinus","volume":"116","author":"T Altay","year":"2012","journal-title":"J Neurosurg"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"869","DOI":"10.3171\/2015.7.JNS15422","article-title":"Lateral orbitotomy for a maxillary nerve schwannoma: case report","volume":"125","author":"S A Wallace","year":"2016","journal-title":"J Neurosurg"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"677","DOI":"10.3171\/2023.6.JNS23678","article-title":"The lateral transorbital approach to the medial sphenoid wing, anterior clinoid, middle fossa, cavernous sinus, and Meckel's cave: target-based classification, approach-related complications, and intermediate-term ocular outcomes","volume":"140","author":"D Mathios","year":"2023","journal-title":"J Neurosurg"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.3171\/2016.4.JNS16290","article-title":"Epstein-Barr virus-associated smooth muscle tumor of the cavernous sinus: a delayed complication of allogenic peripheral blood stem cell transplantation: case report","volume":"126","author":"A Raheja","year":"2017","journal-title":"J Neurosurg"},{"issue":"11","key":"ref21","first-page":"3974","article-title":"Minimal invasive trans-eyelid approach to anterior and middle skull base meningioma: a preliminary study of Shanghai Huashan hospital","volume":"7","author":"Q Xie","year":"2014","journal-title":"Int J Clin Exp Med"},{"issue":"05","key":"ref22","doi-asserted-by":"crossref","first-page":"E164","DOI":"10.1093\/ons\/opz174","article-title":"Resection of cavernous sinus meningioma via lateral orbitotomy approach: 2-dimensional operative video","volume":"18","author":"M A Cohen","year":"2020","journal-title":"Oper Neurosurg (Hagerstown)"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"389","DOI":"10.25259\/SNI_354_2022","article-title":"Modified lateral orbitotomy approach for resection of anterior temporal cavernous malformation","volume":"13","author":"R C Rennert","year":"2022","journal-title":"Surg Neurol Int"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1038\/s41433-021-01850-1","article-title":"Orbito-cranial schwannoma-a multicentre experience","volume":"37","author":"Y Shapira","year":"2023","journal-title":"Eye (Lond)"}],"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1788645.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T22:30:52Z","timestamp":1751668252000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1788645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,31]]},"references-count":23,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,7,4]]},"published-print":{"date-parts":[[2025,8]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1788645","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"value":"2193-6331","type":"print"},{"value":"2193-634X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,31]]}}}