Transorbital Neuroendoscopic Surgery in the Pediatric Population

Transorbital endoscopic surgery is a recently developed surgical field, with gaining popularity in both the adult and pediatric populations. While the literature on pediatric applications is less mature, in our experience, it is safe, highly effective, and minimally disruptive. It can be a very helpful adjunctive portal to either enhance visualization, provide an alternative perspective, or improve instrumentation in a combined multiportal approach. The somewhat confined anatomy in pediatric patients makes the preoperative planning stage critical so that adequate access to the lesion can be obtained in the least disruptive manner. Our practice involves a multidisciplinary discussion, a virtual three-dimensional (3D) representation of the approach, and occasionally printing a 3D model as an additional planning aid or for surgical rehearsal. In this chapter, we describe our planning approach, surgical technique postoperative considerations, and outcomes.