ArticleBrain & spine2025
Neurosurgical robot-assisted transnasal endoscopic surgery in orbital-related diseases.
Article in Brain & spine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Transnasal endoscopic surgery, with its minimal invasiveness and no facial incisions, is increasingly used for orbital-related diseases. Robot-assisted techniques enhance precision, safety, and efficacy, offering significant advantages in treating these complex conditions involving multiple anatomical structures and nterdisciplinary considerations. Research question: This study reports our experience using robot-assisted transnasal endoscopic surgery for orbital-related diseases. Material and methods: We retrospectively analyzed 162 patients (March 2021-July 2024) with orbital-related diseases who underwent robot-assisted transnasal endoscopic surgery: 137 optic nerve injuries, 8 orbital tumors, 8 cranio-orbital communication tumors, 5 orbital abscesses, 4 orbital foreign bodies. Outcomes were assessed via clinical follow-up and imaging. Results: 161 cases achieved satisfactory treatment without serious complications except for one patient underwent endovascular embolization due to intraoperative bleeding caused by pseudoaneurysm rupture. Among optic nerve injury patients, 66/137 (48.18 %) presented with vision improvement, (36/90 (40 %) were effective in those without light perception, 8/11 (72.73 %) were effective in those with light perception, and 22/36 (61.11 %) were effective in those with better light perception). A 100 % removal rate was achieved in orbital tumors, orbital peripheral abscesses, and foreign bodies. 6/8 (75 %) of cranial-orbital communication tumors were resected completely with the remaining two cases identified pathologically as melanoma and lymphoma. Discussion and conclusion: Robot-assisted transnasal endoscopic surgery is a safe, effective and minimally invasive technique, showing potential advantages in procedures of orbital-related diseases such as optic nerve canal decompression, tumor resection, abscess drainage, and foreign body removal. Preoperative vascular-related examinations can be helpful to reduce the surgery-related complications.
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