O-arm in Endonasal Endoscopic Cranial Base Surgery: Technical Note on Initial Feasibility

Liverana Lauretti, Quintino Giorgio D'Alessandris, Mario Rigante, Luca Ricciardi, Pier Paolo Mattogno, Alessandro Olivi

Research output: Contribution to journalArticlepeer-review


Background: In transsphenoidal endoscopic cranial base surgery, a precise navigational support may be crucial. This is particularly evident when tumors extend to the parasellar region or in recurrent tumors whereas normal anatomy has been altered by previous surgery/radiotherapy. Methods: Previous unsatisfactory experiences with various navigation techniques in this type of surgery encouraged us to perform an endoscopic endonasal approach with an O-arm (Medtronic, Inc., Minneapolis, Minnesota, USA) assisted technique for the surgical treatment of 4 patients affected respectively by an orbital tumor and 3 cases of relapse of nonfunctioning pituitary adenoma, 1 of them localized in the infrasellar-clival region. Results: The system O-arm-StealthStation allows for merging intraoperative bone 3-D acquisition with preoperative computed tomography/magnetic resonance imaging and provides the surgeon with an extremely reliable operative navigational tool. Conclusions: This is the first report of an O-arm-assisted endoscopic surgery for cranial base tumors. Here we report on the feasibility and usefulness of such a new application of the O-arm: technical details, setting of the operating room, advantages, and limits of the method are also described. Our overall impression, considering the limited number of patients, is that use of the O-arm may be successfully extended to selected cases of cranial base tumors operated through an endoscopic endonasal approach.

Original languageEnglish (US)
Pages (from-to)103-108
Number of pages6
JournalWorld neurosurgery
StatePublished - Sep 2018
Externally publishedYes


  • Endonasal approach
  • Endoscopic skull base surgery
  • Neuronavigation
  • O-arm

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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