Transorbital neuroendoscopic surgery (TONES), surgeons claim, is safe and effective in treating advanced brain diseases and traumatic injuries.
Surgeons at the University of California, San Diego, School of Medicine and University of Washington Medical Center say this groundbreaking minimally invasive surgery is performed through the eye socket, thus eliminating the removal of the top of the skull to access the brain.
To achieve access, the surgeons make a small incision behind or through the eyelid. A tiny hole is then made through the paper-thin bone of the eye socket to reach the brain. This pathway permits repairs to be made without lifting the brain. The TONES approaches also protect the optic nerves, the nerves for smell, as well as the carotid and ophthalmic arteries.
In a traditional craniotomy, a large portion of skull bone is removed. With TONES, the area of bone removed is only two to three centimeters. The operating time is much shorter since the skull does not need to be repaired and there is no need to close a large incision.
Patients underwent the TONES procedure to repair cerebral spinal fluid leaks, optic nerve decompression, repair of cranial base fractures and removal of tumors.
TONES is currently performed at only two institutions in the world: UC San Diego Medical Center and the University of Washington Medical Center.
The findings have been published in the September issue of Neurosurgery.