ArticleSurgical neurology international2025
Lateral transorbital neuroendoscopic approach using the superior eyelid incision: A straightforward, comprehensive, and illustrative step-by-step review.
Article in Surgical neurology international, 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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13 authors.
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Abstract
Background: The lateral transorbital neuroendoscopic approach (TONES) is progressively gaining popularity. Recent studies have emphasized its feasibility and potential applications. A thorough understanding of the anatomy and the phases of this approach is essential for developing confidence in its execution. Methods: A step-by-step description of the transpalpebral TONES approach, accompanied by detailed, illustrative images, was provided using recent and most relevant publications. High-definition images of the orbit were created using the photo stacking technique. Digital drawings of the approach steps were optimized and simplified, eliminating distractions, using Procreate. Brainlab 3D Elements and SmartBrush 5.0 were used for patient images. Results: The text was divided into two main headings: anatomy and surgery. Both main portions involved detailed descriptions of the most critical and influential characteristics of the TONES. Straightforward anatomical illustrations were used to simplify the learning of the endoscopic transorbital perspective and steps of the TONES approach. Conclusion: A stepwise, comprehensive, and straightforward review of this emerging approach is essential for the learning community in endoscopic skull base surgery. TONES is estimated to increase from a feasibility perspective, guiding the development of lateral skull base access options. We believe it will be similar to the evolution of the endonasal endoscopic approach.
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