{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T11:19:01Z","timestamp":1779880741064,"version":"3.53.1"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,2,2]]},"abstract":"\n BACKGROUND<\/jats:title>\n Esthesioneuroblastoma (ENB) is a rare malignant tumor originating from the olfactory epithelium, often involving the anterior skull base with intracranial extension. Surgical management options include the transcranial approach combined with the endoscopic endonasal approach (EEA) or purely EEA. However, conventional indications for EEA are limited to tumors with lateral extension not exceeding the midorbital line, due to restricted lateral exposure. Logically, extending the resection of the orbital roof bone can enhance lateral access, potentially expanding the surgical indications for EEA in selected cases.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A young male patient presented with epistaxis and was diagnosed with a giant ENB involving the nasal cavity and anterior skull base. Through an EEA, extended resection of the orbital roof was performed to achieve gross-total tumor removal. The patient recovered uneventfully, with no neurological deficits, and follow-up at 6 months showed no evidence of tumor recurrence.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n The EEA offers inherent advantages, such as avoiding brain retraction and minimizing invasiveness. With improved understanding of skull base anatomy, the indications for EEA can be expanded beyond traditional limits, including tumors extending lateral to the midorbital line. In appropriate cases, this approach may obviate the need for craniotomy, reducing surgical morbidity.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25914<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25914","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T13:30:00Z","timestamp":1770298200000},"source":"Crossref","is-referenced-by-count":1,"title":["Endoscopic endonasal approach with extended orbital roof removal for a giant esthesioneuroblastoma: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5487-8316","authenticated-orcid":true,"given":"Liping","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, HuZhou Central Hospital, Zhejiang University, HuZhou City, Zhejiang Province"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2236-5158","authenticated-orcid":true,"given":"Guohong","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, HuZhou Central Hospital, Zhejiang University, HuZhou City, Zhejiang Province"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai"},{"name":"Shanghai Key Lab of Medical Image Computing and Computer Assisted Intervention, Shanghai Medical College, Fudan University, Shanghai, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Curr Oncol Rep","first-page":"7","article-title":"Olfactory neuroblastoma","volume":"20","author":"Abdelmeguid","year":"2018","unstructured":"Abdelmeguid AS.Olfactory neuroblastoma. Curr Oncol Rep. 2018;20(1):7."},{"issue":"12","key":"bib2","series-title":"Nat Cancer","first-page":"1919","article-title":"Single-cell transcriptomic landscape deciphers olfactory neuroblastoma subtypes and intra-tumoral heterogeneity","volume":"5","author":"Yang","year":"2024","unstructured":"Yang JSong XZhang HSingle-cell transcriptomic landscape deciphers olfactory neuroblastoma subtypes and intra-tumoral heterogeneity. Nat Cancer. 2024;5(12):1919-1939."},{"key":"bib3","series-title":"World Neurosurg","first-page":"190","article-title":"The basal subarachnoid cisterns: surgical and anatomical considerations","volume":"129","author":"Altafulla","year":"2019","unstructured":"Altafulla JBordes SJenkins SThe basal subarachnoid cisterns: surgical and anatomical considerations. World Neurosurg. 2019;129:190-199."},{"key":"bib4","series-title":"World Neurosurg","first-page":"194","article-title":"Esthesioneuroblastoma: a comprehensive review of diagnosis, management, and current treatment options","volume":"126","author":"Fiani","year":"2019","unstructured":"Fiani BQuadri SACathel AEsthesioneuroblastoma: a comprehensive review of diagnosis, management, and current treatment options. World Neurosurg. 2019;126:194-211."},{"issue":"3","key":"bib5","series-title":"J Neurooncol","first-page":"367","article-title":"Management of olfactory neuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma involving the skullbase","volume":"150","author":"Mehta","year":"2020","unstructured":"Mehta GURaza SMSu SYHanna EYDeMonte F.Management of olfactory neuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma involving the skullbase. J Neurooncol. 2020;150(3):367-375."},{"key":"bib6","series-title":"Front Oncol","first-page":"1247","article-title":"Treatment strategies and outcomes of pediatric esthesioneuroblastoma: a systematic review","volume":"10","author":"Safi","year":"2020","unstructured":"Safi CSpielman DOtten MTreatment strategies and outcomes of pediatric esthesioneuroblastoma: a systematic review. Front Oncol. 2020;10:1247."},{"issue":"1","key":"bib7","series-title":"Radiat Oncol","first-page":"219","article-title":"Long-term analysis of multimodality treatment outcomes and prognosis of esthesioneuroblastomas: a single center results of 138 patients","volume":"15","author":"Sun","year":"2020","unstructured":"Sun MWang KQu YLong-term analysis of multimodality treatment outcomes and prognosis of esthesioneuroblastomas: a single center results of 138 patients. Radiat Oncol. 2020;15(1):219."},{"issue":"2","key":"bib8","series-title":"Ann Otol Rhinol Laryngol","first-page":"136","article-title":"Comparison of open and endoscopic approaches in the resection of esthesioneuroblastoma","volume":"130","author":"Barinsky","year":"2021","unstructured":"Barinsky GLAzmy MCKilic SComparison of open and endoscopic approaches in the resection of esthesioneuroblastoma. Ann Otol Rhinol Laryngol. 2021;130(2):136-141."},{"issue":"3","key":"bib9","series-title":"J Neurosurg","first-page":"848","article-title":"Defining the lateral limits of the endoscopic endonasal transtuberculum transplanum approach: anatomical study with pertinent quantitative analysis","volume":"130","author":"Di Somma","year":"2019","unstructured":"Di Somma ATorales JCavallo LMDefining the lateral limits of the endoscopic endonasal transtuberculum transplanum approach: anatomical study with pertinent quantitative analysis. J Neurosurg. 2019;130(3):848-860."},{"issue":"1","key":"bib10","series-title":"J Neurosurg Pediatr","first-page":"73","article-title":"Systematic review of transcranial and endoscopic endonasal approaches for craniopharyngiomas in children: is there an evolution?","volume":"33","author":"D\u2019Avella","year":"2024","unstructured":"D\u2019Avella EVitulli FBerardinelli JSystematic review of transcranial and endoscopic endonasal approaches for craniopharyngiomas in children: is there an evolution? J Neurosurg Pediatr. 2024;33(1):73-84."},{"issue":"3","key":"bib11","series-title":"J Neurooncol","first-page":"461","article-title":"Modern endoscopic skull base neurosurgery","volume":"151","author":"Martinez-Perez","year":"2021","unstructured":"Martinez-Perez RRequena LCCarrau RLPrevedello DM.Modern endoscopic skull base neurosurgery. J Neurooncol. 2021;151(3):461-475."},{"issue":"4","key":"bib12","series-title":"J Neurol Surg B Skull Base","first-page":"375","article-title":"Evolution of surgical outcomes in endoscopic endonasal resection of craniopharyngiomas","volume":"84","author":"Yu","year":"2023","unstructured":"Yu STaghvaei MReyes MEvolution of surgical outcomes in endoscopic endonasal resection of craniopharyngiomas. J Neurol Surg B Skull Base. 2023;84(4):375-383."},{"issue":"6","key":"bib13","series-title":"J Neurol Surg B Skull Base","first-page":"575","article-title":"Anatomical step-by-step dissection of complex skull base approaches for trainees: surgical anatomy of the endoscopic endonasal approach to the anterior cranial fossa","volume":"85","author":"Agosti","year":"2024","unstructured":"Agosti EAlexander AYLeonel LCPCAnatomical step-by-step dissection of complex skull base approaches for trainees: surgical anatomy of the endoscopic endonasal approach to the anterior cranial fossa. J Neurol Surg B Skull Base. 2024;85(6):575-586."},{"key":"bib14","series-title":"World Neurosurg","first-page":"e666","article-title":"Minimally invasive approaches for anterior skull base meningiomas: supraorbital eyebrow, endoscopic endonasal, or a combination of both? Anatomic study, limitations, and surgical application","volume":"112","author":"Borghei-Razavi","year":"2018","unstructured":"Borghei-Razavi HTruong HQFernandes-Cabral DTMinimally invasive approaches for anterior skull base meningiomas: supraorbital eyebrow, endoscopic endonasal, or a combination of both? Anatomic study, limitations, and surgical application. World Neurosurg. 2018;112:e666-e674."},{"issue":"2","key":"bib15","series-title":"Turk Neurosurg","first-page":"272","article-title":"Endoscopic endonasal approach limitations and evolutions for tuberculum sellae meningiomas: data from single-center experience of sixty patients","volume":"33","author":"Caklili","year":"2023","unstructured":"Caklili MEmengen AYilmaz EEndoscopic endonasal approach limitations and evolutions for tuberculum sellae meningiomas: data from single-center experience of sixty patients. Turk Neurosurg. 2023;33(2):272-282."},{"issue":"2","key":"bib16","series-title":"Oper Neurosurg","first-page":"E71","article-title":"Endoscopic endonasal and supraorbital removal of tuberculum sellae meningiomas: anatomic guides and operative nuances for keyhole approach selection","volume":"21","author":"Mallari","year":"2021","unstructured":"Mallari RJThakur JDRhee JHEndoscopic endonasal and supraorbital removal of tuberculum sellae meningiomas: anatomic guides and operative nuances for keyhole approach selection. Oper Neurosurg. 2021;21(2):E71-E81."},{"issue":"5","key":"bib17","series-title":"Oper Neurosurg","first-page":"E144","article-title":"Endoscopic endonasal resection of orbital apex cavernous hemangioma: 2-dimensional operative video","volume":"16","author":"Marcellino","year":"2019","unstructured":"Marcellino CRPeris-Celda MLink MJStokken JK.Endoscopic endonasal resection of orbital apex cavernous hemangioma: 2-dimensional operative video. Oper Neurosurg. 2019;16(5):E144-E145."},{"issue":"3","key":"bib18","series-title":"Can J Neurol Sci","first-page":"496","article-title":"Outcomes of endoscopic endonasal surgery for tuberculum sellae and planum sphenoidale meningiomas: a retrospective study","volume":"52","author":"Schroeder","year":"2024","unstructured":"Schroeder LAStarreveld YP.Outcomes of endoscopic endonasal surgery for tuberculum sellae and planum sphenoidale meningiomas: a retrospective study. Can J Neurol Sci. 2024;52(3):496-501."},{"key":"bib19","series-title":"J Clin Neurosci","first-page":"93","article-title":"Endoscopic endonasal approach for olfactory groove meningioma resection: strategies and outcomes in a retrospective case series","volume":"122","author":"Wang","year":"2024","unstructured":"Wang AJLee CKBlanch MEndoscopic endonasal approach for olfactory groove meningioma resection: strategies and outcomes in a retrospective case series. J Clin Neurosci. 2024;122:93-102."},{"issue":"1","key":"bib1","series-title":"Curr Oncol Rep","first-page":"7","article-title":"Olfactory neuroblastoma","volume":"20","author":"Abdelmeguid","year":"2018","unstructured":"Abdelmeguid AS.Olfactory neuroblastoma. Curr Oncol Rep. 2018;20(1):7."},{"issue":"12","key":"bib2","series-title":"Nat Cancer","first-page":"1919","article-title":"Single-cell transcriptomic landscape deciphers olfactory neuroblastoma subtypes and intra-tumoral heterogeneity","volume":"5","author":"Yang","year":"2024","unstructured":"Yang JSong XZhang HSingle-cell transcriptomic landscape deciphers olfactory neuroblastoma subtypes and intra-tumoral heterogeneity. Nat Cancer. 2024;5(12):1919-1939."},{"key":"bib3","series-title":"World Neurosurg","first-page":"190","article-title":"The basal subarachnoid cisterns: surgical and anatomical considerations","volume":"129","author":"Altafulla","year":"2019","unstructured":"Altafulla JBordes SJenkins SThe basal subarachnoid cisterns: surgical and anatomical considerations. World Neurosurg. 2019;129:190-199."},{"key":"bib4","series-title":"World Neurosurg","first-page":"194","article-title":"Esthesioneuroblastoma: a comprehensive review of diagnosis, management, and current treatment options","volume":"126","author":"Fiani","year":"2019","unstructured":"Fiani BQuadri SACathel AEsthesioneuroblastoma: a comprehensive review of diagnosis, management, and current treatment options. World Neurosurg. 2019;126:194-211."},{"issue":"3","key":"bib5","series-title":"J Neurooncol","first-page":"367","article-title":"Management of olfactory neuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma involving the skullbase","volume":"150","author":"Mehta","year":"2020","unstructured":"Mehta GURaza SMSu SYHanna EYDeMonte F.Management of olfactory neuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma involving the skullbase. J Neurooncol. 2020;150(3):367-375."},{"key":"bib6","series-title":"Front Oncol","first-page":"1247","article-title":"Treatment strategies and outcomes of pediatric esthesioneuroblastoma: a systematic review","volume":"10","author":"Safi","year":"2020","unstructured":"Safi CSpielman DOtten MTreatment strategies and outcomes of pediatric esthesioneuroblastoma: a systematic review. Front Oncol. 2020;10:1247."},{"issue":"1","key":"bib7","series-title":"Radiat Oncol","first-page":"219","article-title":"Long-term analysis of multimodality treatment outcomes and prognosis of esthesioneuroblastomas: a single center results of 138 patients","volume":"15","author":"Sun","year":"2020","unstructured":"Sun MWang KQu YLong-term analysis of multimodality treatment outcomes and prognosis of esthesioneuroblastomas: a single center results of 138 patients. Radiat Oncol. 2020;15(1):219."},{"issue":"2","key":"bib8","series-title":"Ann Otol Rhinol Laryngol","first-page":"136","article-title":"Comparison of open and endoscopic approaches in the resection of esthesioneuroblastoma","volume":"130","author":"Barinsky","year":"2021","unstructured":"Barinsky GLAzmy MCKilic SComparison of open and endoscopic approaches in the resection of esthesioneuroblastoma. Ann Otol Rhinol Laryngol. 2021;130(2):136-141."},{"issue":"3","key":"bib9","series-title":"J Neurosurg","first-page":"848","article-title":"Defining the lateral limits of the endoscopic endonasal transtuberculum transplanum approach: anatomical study with pertinent quantitative analysis","volume":"130","author":"Di Somma","year":"2019","unstructured":"Di Somma ATorales JCavallo LMDefining the lateral limits of the endoscopic endonasal transtuberculum transplanum approach: anatomical study with pertinent quantitative analysis. J Neurosurg. 2019;130(3):848-860."},{"issue":"1","key":"bib10","series-title":"J Neurosurg Pediatr","first-page":"73","article-title":"Systematic review of transcranial and endoscopic endonasal approaches for craniopharyngiomas in children: is there an evolution?","volume":"33","author":"D\u2019Avella","year":"2024","unstructured":"D\u2019Avella EVitulli FBerardinelli JSystematic review of transcranial and endoscopic endonasal approaches for craniopharyngiomas in children: is there an evolution? J Neurosurg Pediatr. 2024;33(1):73-84."},{"issue":"3","key":"bib11","series-title":"J Neurooncol","first-page":"461","article-title":"Modern endoscopic skull base neurosurgery","volume":"151","author":"Martinez-Perez","year":"2021","unstructured":"Martinez-Perez RRequena LCCarrau RLPrevedello DM.Modern endoscopic skull base neurosurgery. J Neurooncol. 2021;151(3):461-475."},{"issue":"4","key":"bib12","series-title":"J Neurol Surg B Skull Base","first-page":"375","article-title":"Evolution of surgical outcomes in endoscopic endonasal resection of craniopharyngiomas","volume":"84","author":"Yu","year":"2023","unstructured":"Yu STaghvaei MReyes MEvolution of surgical outcomes in endoscopic endonasal resection of craniopharyngiomas. J Neurol Surg B Skull Base. 2023;84(4):375-383."},{"issue":"6","key":"bib13","series-title":"J Neurol Surg B Skull Base","first-page":"575","article-title":"Anatomical step-by-step dissection of complex skull base approaches for trainees: surgical anatomy of the endoscopic endonasal approach to the anterior cranial fossa","volume":"85","author":"Agosti","year":"2024","unstructured":"Agosti EAlexander AYLeonel LCPCAnatomical step-by-step dissection of complex skull base approaches for trainees: surgical anatomy of the endoscopic endonasal approach to the anterior cranial fossa. J Neurol Surg B Skull Base. 2024;85(6):575-586."},{"key":"bib14","series-title":"World Neurosurg","first-page":"e666","article-title":"Minimally invasive approaches for anterior skull base meningiomas: supraorbital eyebrow, endoscopic endonasal, or a combination of both? Anatomic study, limitations, and surgical application","volume":"112","author":"Borghei-Razavi","year":"2018","unstructured":"Borghei-Razavi HTruong HQFernandes-Cabral DTMinimally invasive approaches for anterior skull base meningiomas: supraorbital eyebrow, endoscopic endonasal, or a combination of both? Anatomic study, limitations, and surgical application. World Neurosurg. 2018;112:e666-e674."},{"issue":"2","key":"bib15","series-title":"Turk Neurosurg","first-page":"272","article-title":"Endoscopic endonasal approach limitations and evolutions for tuberculum sellae meningiomas: data from single-center experience of sixty patients","volume":"33","author":"Caklili","year":"2023","unstructured":"Caklili MEmengen AYilmaz EEndoscopic endonasal approach limitations and evolutions for tuberculum sellae meningiomas: data from single-center experience of sixty patients. Turk Neurosurg. 2023;33(2):272-282."},{"issue":"2","key":"bib16","series-title":"Oper Neurosurg","first-page":"E71","article-title":"Endoscopic endonasal and supraorbital removal of tuberculum sellae meningiomas: anatomic guides and operative nuances for keyhole approach selection","volume":"21","author":"Mallari","year":"2021","unstructured":"Mallari RJThakur JDRhee JHEndoscopic endonasal and supraorbital removal of tuberculum sellae meningiomas: anatomic guides and operative nuances for keyhole approach selection. Oper Neurosurg. 2021;21(2):E71-E81."},{"issue":"5","key":"bib17","series-title":"Oper Neurosurg","first-page":"E144","article-title":"Endoscopic endonasal resection of orbital apex cavernous hemangioma: 2-dimensional operative video","volume":"16","author":"Marcellino","year":"2019","unstructured":"Marcellino CRPeris-Celda MLink MJStokken JK.Endoscopic endonasal resection of orbital apex cavernous hemangioma: 2-dimensional operative video. Oper Neurosurg. 2019;16(5):E144-E145."},{"issue":"3","key":"bib18","series-title":"Can J Neurol Sci","first-page":"496","article-title":"Outcomes of endoscopic endonasal surgery for tuberculum sellae and planum sphenoidale meningiomas: a retrospective study","volume":"52","author":"Schroeder","year":"2024","unstructured":"Schroeder LAStarreveld YP.Outcomes of endoscopic endonasal surgery for tuberculum sellae and planum sphenoidale meningiomas: a retrospective study. Can J Neurol Sci. 2024;52(3):496-501."},{"key":"bib19","series-title":"J Clin Neurosci","first-page":"93","article-title":"Endoscopic endonasal approach for olfactory groove meningioma resection: strategies and outcomes in a retrospective case series","volume":"122","author":"Wang","year":"2024","unstructured":"Wang AJLee CKBlanch MEndoscopic endonasal approach for olfactory groove meningioma resection: strategies and outcomes in a retrospective case series. 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