{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T18:03:42Z","timestamp":1786125822974,"version":"build-2736575974"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T00:00:00Z","timestamp":1611964800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/ mailto:journals.permissions@oup.com"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Orbital metastatic lesions are rare entities\n                    <jats:sup>1-3<\/jats:sup>\n                    best treated with radical surgical resection with preservation\/improvement of neurological and visual function.\n                    <jats:sup>1-9<\/jats:sup>\n                    Renal cell metastases, in particular, respond less favorably to radiation.\n                    <jats:sup>9<\/jats:sup>\n                    To our knowledge, an operative video of microsurgical resection of a renal cell carcinoma metastasis to the superior orbital fissure and orbit has not been reported.\n                  <\/jats:p>\n                  <jats:p>\n                    A patient presented with worsening right eye vision as demonstrated on preoperative visual field testing and found to have a 3\u00a0\u00d7\u00a01\u00a0\u00d7\u00a01 cm lesion in the orbit and superior orbital fissure. The patient was placed supine and stealth neuronavigation was used to aid in tumor localization and extension. A cranio-orbital craniotomy and pretemporal exposure\n                    <jats:sup>2,10,11<\/jats:sup>\n                    were performed to allow extradural dissection of the dura propria off the lateral wall of the cavernous sinus. Right-sided extradural cranial nerves II, III, IV, V1, and V2 were identified, and a high-speed diamond drill was used to perform extradural anterior clinoidectomy and optic nerve decompression. Microsurgical resection of the intraorbital tumor components was performed by the senior author (KIA) to delineate the plane between tumor and periorbita. An oval-shaped dural opening was made to resect the dura involved by tumor, confirmed on histological analysis, followed by closure via dural allograft. The patient's right-sided visual field improved markedly after surgery.\n                  <\/jats:p>\n                  <jats:p>Metastatic renal cell carcinoma of the orbit should be resected while preserving and improving preoperative neurological and visual function. The orbitocranial pretemporal approach offers wide visualization to achieve surgical resection.<\/jats:p>\n                  <jats:p>The patient provided written consent and permission to publish her image.<\/jats:p>","DOI":"10.1093\/ons\/opaa453","type":"journal-article","created":{"date-parts":[[2021,1,31]],"date-time":"2021-01-31T01:46:26Z","timestamp":1612057586000},"page":"E364-E365","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Cranio-Orbital Pretemporal Approach for Resection of Right Superior Orbital Fissure\/Orbital Renal Cell Metastasis: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"20","author":[{"given":"Vincent N","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4099-089X","authenticated-orcid":false,"given":"Nickalus R","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3745-288X","authenticated-orcid":false,"given":"Kenan I","family":"Arnautovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee"},{"name":"Semmes Murphey Neurologic & Spine Institute, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,5]]},"reference":[{"key":"bib1-20251027","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1016\/j.surneu.2007.02.014","article-title":"Orbitozygomatic approach for excisions of orbital tumors with 1 piece of craniotomy bone flap: 2 case reports","volume":"68(Suppl 1)","author":"Chang","year":"2007","journal-title":"Surg Neurol"},{"key":"bib2-20251027","doi-asserted-by":"crossref","first-page":"e398","DOI":"10.1016\/j.wneu.2018.09.120","article-title":"Pterional, pretemporal, and orbitozygomatic approaches: anatomic and comparative study","volume":"121","author":"da Silva","year":"2019","journal-title":"World Neurosurg"},{"issue":"9","key":"bib3-20251027","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1007\/s00701-006-0859-5","article-title":"Surgical exposure of lateral orbital lesions using a coronal scalp flap and lateral orbitozygomatic approach: clinical experience","volume":"148","author":"Paolini","year":"2006","journal-title":"Acta Neurochir (Wien)"},{"issue":"4","key":"bib4-20251027","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.rpor.2014.09.002","article-title":"Surgical management of skull base tumors","volume":"21","author":"Rangel-Castilla","year":"2016","journal-title":"Rep Pract Oncol Radiother"},{"issue":"5","key":"bib5-20251027","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.jocn.2014.11.002","article-title":"Surgical management, outcomes, and recurrence rate of orbital lymphangiomas","volume":"22","author":"Russin","year":"2015","journal-title":"J Clin Neurosci"},{"issue":"2","key":"bib6-20251027","doi-asserted-by":"crossref","first-page":"336","DOI":"10.3171\/jns.1998.89.2.0336","article-title":"Orbitozygomatic craniotomy. 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