Transorbital Neuroendoscopic Surgery (TONES)
At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can access exceptional care for skull/cranial base and orbit-related conditions using transorbital neuroendoscopic surgery (TONES). As a global leader in otorhinolaryngology and head and neck surgery, we are an academic-based, national and international referral site for the most complex and high-risk cases. For over a century, we have been at the forefront of innovation, research and clinical care for ear, nose and throat (ENT) and head and neck conditions.
Ranked in the top 1% of all hospitals in the nation for complex specialty care according to U.S. News & World Report, Montefiore Einstein continues to make advances in the diagnosis and treatment of ENT and head and neck conditions. Our Comprehensive Skull/Cranial Base Center is one of the first and few centers in the nation to routinely offer TONES.
Our dedicated, multidisciplinary TONES team comprises world-renowned otorhinolaryngologists and head and neck surgeons, neurosurgeons, facial plastic and oculoplastic surgeons, plastic and reconstructive surgeons, medical and radiation oncologists, critical care specialists, endocrinologists and neuro-ophthalmologists. These thought leaders in the field train and teach physicians and academic institutions around the world about the TONES approach. Our surgeons also published one of the first textbooks to describe the TONES approach in detail, highlighting our Center’s innovations and expertise.
At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can expect compassionate, personalized, research-based treatment plans that meet the highest standards for quality and safety.
When you need care for skull/cranial base and orbit-related conditions using TONES, turn to our dedicated providers who will develop a highly personalized treatment plan.
What Is TONES?
Transorbital neuroendoscopic surgery (TONES) is an advanced, minimally invasive procedure performed through the orbit (eye socket), which may not require any incisions, while preserving the patient’s vision. TONES unites the endoscopic approach of pituitary surgery with microscopic tumor resection while maximizing surgical visualization. TONES encompasses a group of approaches, including the precaruncular, preseptal lower eyelid, superior eyelid crease and lateral retrocanthal approaches.
What Conditions Can Be Treated with TONES?
The TONES technique allows for minimally invasive access to numerous complex conditions and intracranial pathologies through the eye. These conditions include:
- Vascular conditions such as aneurysms
- Congenital abnormalities
- Traumatic injuries, such as orbital and skull base fractures and cerebrospinal fluid (CSF) leaks
- Inflammatory conditions
- Infections, including intracranial abscesses
- Optic nerve pathologies
- A wide range of benign and malignant brain and head and neck tumors involving the base of the skull, such as meningiomas, pituitary adenomas, vestibular schwannomas, acoustic neuromas, Rathke’s cleft cysts and sinonasal cancers
What Are the Benefits of TONES?
TONES may minimize surgical morbidity and cosmetic deformity compared to standard open craniofacial approaches and allow for shorter recovery times. It also may allow access to certain skull/cranial base lesions that are difficult to reach through expanded transnasal endoscopic procedures.