title: Supraorbital subfrontal trans-laminar endoscope-assisted approach for tumors of the posterior third ventricle.
abstract: Different surgical approaches have been developed for dealing with third ventricle lesions, all aimed at obtaining a safe removal minimizing brain manipulation. The supraorbital subfrontal trans-lamina terminalis route, commonly employed only for the anterior third ventricle, could represent, in selected cases with endoscopic assistance, an alternative approach to posterior third ventricular lesions.
  
  
  
  Seven patients underwent a supraorbital subfrontal trans-laminar endoscope-assisted approach to posterior third ventricle tumors (two craniopharyngiomas, one papillary tumor of the pineal region, one pineocytoma, two neurocytomas, one glioblastoma). Moreover, a conventional third ventriculostomy was performed via the same trans-laminar approach in four cases.
  
  
  
  Complete tumor removal was accomplished in four cases, subtotal removal in two cases, and a simple biopsy in one case. Adjuvant radiotherapy and/or chemotherapy was administered, if required, on the basis of the histologic diagnosis. No major complications occurred after surgery except for an intratumoral hemorrhage in a patient undergoing a biopsy for a glioblastoma, which simply delayed the beginning of adjuvant radiochemotherapy. No ventriculoperitoneal shunt placement was needed in these patients at the most recent clinical and radiologic session (average 39.57 months, range 13-85 months). Two illustrative cases are presented.
  
  
  
  The supraorbital subfrontal trans-laminar endoscope-assisted approach may provide, in selected cases, an efficient and safe route for dealing with posterior third ventricular tumors.
authors.affiliation: Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Via Conca #71, Ancona, 60020, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Iacoangeli
authors.affiliation: Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Via Conca #71, Ancona, 60020, Italy. roberto.colasanti@gmail.com.
authors.forename: Roberto
authors.identifier: 0000-0001-5026-8089
authors.initials: R
authors.lastname: Colasanti
authors.affiliation: Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Via Conca #71, Ancona, 60020, Italy.
authors.forename: Domenic
authors.initials: D
authors.lastname: Esposito
authors.affiliation: Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Via Conca #71, Ancona, 60020, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Di Rienzo
authors.affiliation: Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Via Conca #71, Ancona, 60020, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: di Somma
authors.affiliation: Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Via Conca #71, Ancona, 60020, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Dobran
authors.affiliation: Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Via Conca #71, Ancona, 60020, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gladi
authors.affiliation: Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Via Conca #71, Ancona, 60020, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Scerrati
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D059186:Chemoradiotherapy, Adjuvant; D002648:Child; D019723:Endoscopes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D009915:Orbit / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D020542:Third Ventricle / Q000601:surgery*; D014696:Ventriculostomy / Q000009:adverse effects / Q000379:methods*
keywords: Endoscopic assistance; Key-hole approach; Minimally invasive surgery; Posterior third ventricle tumor; Supraorbital subfrontal approach; Trans-lamina terminalis