{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:26:50Z","timestamp":1790864810794,"version":"4.1.0"},"reference-count":80,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The aim of this study was to evaluate the efficacy and safety of transorbital neuroendoscopic surgery (TONES) in the management of sphenoid wing meningiomas (SWMs) with cavernous sinus and orbital invasion.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors conducted a retrospective review of 32 patients with SWMs treated at Gazi University using TONES from October 2019 to May 2023. The study includes clinical applications to elucidate the endoscopic transorbital approach. Surgical techniques focused on safe subtotal resection, aiming to minimize residual tumor volume for subsequent radiosurgery. Data were collected on patient demographics, tumor characteristics, surgical procedures, complications, and postoperative outcomes, including radiological imaging and ophthalmological evaluations.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Surgical dissections delineated a three-phase endoscopic transorbital approach: extraorbital, intraorbital, and intracranial. In the clinical application, gross-total resection was not achieved in any patient because of planned postoperative Gamma Knife radiosurgery. The mean follow-up period was 16.3 months. Of 30 patients with preoperative proptosis, 25 experienced postoperative improvement. No new-onset extraocular muscle paresis or visual loss occurred postoperatively. The average hospital stay was 1.15 days, with minimal complications and no significant morbidity or mortality.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Total resection of SWMs invading the cavernous sinus and orbit is associated with substantial risks, particularly cranial nerve deficits. TONES offers a minimally invasive alternative, reducing morbidity compared with transcranial approaches, and represents a significant advancement in the surgical management of SWMs, especially those extending into the cavernous sinus and orbit. The approach provides a safe, effective, and patient-centric approach, prioritizing subtotal resection to minimize neurological deficits while preparing patients for adjunctive radiosurgery. This study positions TONES as a transformative surgical technique, aligning therapeutic efficacy with neurovascular preservation and postoperative recovery.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2024.1.focus23857","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T02:18:27Z","timestamp":1711937907000},"page":"E8","source":"Crossref","is-referenced-by-count":18,"title":["Transorbital neuroendoscopic surgery for treatment of sphenoid wing meningiomas extending to the cavernous sinus: clinical implications and a technical illustration"],"prefix":"10.3171","volume":"56","author":[{"given":"Gardashkhan","family":"Kar\u0131mzada","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkiye;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demet","family":"Evleksiz Kar\u0131mzada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkiye;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6kberk","family":"Erol","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ministry of Health Elmadag Hulusi Alatas State Hospital, Ankara, Turkiye;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beste","family":"G\u00fclsuna","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pelin","family":"Kuzucu","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abuzer","family":"G\u00fcng\u00f6r","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istinye University, Faculty of Medicine, Istanbul, Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Murat","family":"Kutlay","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkiye;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muammer Melih","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology, Gazi University Faculty of Medicine, Ankara, Turkiye; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emrah","family":"\u00c7eltik\u00e7i","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"b1","series-title":"Acta Neurochir (Wien)","first-page":"1633","article-title":"Endoscopic endo- and extra-orbital corridors for spheno-orbital region: anatomic study with illustrative case","volume":"161","author":"De Rosa A","year":"2019","unstructured":"De Rosa A, Pineda J, Cavallo LM, Endoscopic endo- and extra-orbital corridors for spheno-orbital region: anatomic study with illustrative case. 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