David A Wilson1, Huy Duong2, Charles Teo3, Daniel F Kelly4. 1. Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA; Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia. 2. Brain Tumor Center & Pituitary Disorders Program, John Wayne Cancer Institute and Saint John's Health Center, Santa Monica, California, USA. 3. Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia. 4. Brain Tumor Center & Pituitary Disorders Program, John Wayne Cancer Institute and Saint John's Health Center, Santa Monica, California, USA. Electronic address: kellyd@jwci.org.
Abstract
BACKGROUND: The supraorbital eyebrow craniotomy is being increasingly used for the removal of frontal fossa, parasellar, as well as some middle and posterior fossa tumors. METHODS: The indications, technical nuances, and complication avoidance techniques for the supraorbital keyhole approach with endoscopic assistance are described. RESULTS: The supraorbital approach is considered ideal for removal of many, if not most, planum and tuberculum sellae meningiomas, some olfactory groove meningiomas, as well as suprasellar craniopharyngiomas, particularly those with far lateral extensions. It is also ideal for many intra-axial tumors, including metastases and gliomas arising from the orbitofrontal, frontal pole, and medial temporal lobe regions. The use of endoscopy further extends the range and versatility of this keyhole approach and is considered an essential adjunct for allowing safe and maximal tumor removal. CONCLUSIONS: The supraorbital eyebrow craniotomy with endoscopic assistance provides minimally invasive access to a wide range of frontal fossa, parasellar, and some middle and posterior fossa tumors.
BACKGROUND: The supraorbital eyebrow craniotomy is being increasingly used for the removal of frontal fossa, parasellar, as well as some middle and posterior fossa tumors. METHODS: The indications, technical nuances, and complication avoidance techniques for the supraorbital keyhole approach with endoscopic assistance are described. RESULTS: The supraorbital approach is considered ideal for removal of many, if not most, planum and tuberculum sellae meningiomas, some olfactory groove meningiomas, as well as suprasellar craniopharyngiomas, particularly those with far lateral extensions. It is also ideal for many intra-axial tumors, including metastases and gliomas arising from the orbitofrontal, frontal pole, and medial temporal lobe regions. The use of endoscopy further extends the range and versatility of this keyhole approach and is considered an essential adjunct for allowing safe and maximal tumor removal. CONCLUSIONS: The supraorbital eyebrow craniotomy with endoscopic assistance provides minimally invasive access to a wide range of frontal fossa, parasellar, and some middle and posterior fossa tumors.
Authors: J Manuel Revuelta Barbero; Rima S Rindler; Clara Martin; Marcelo Orellana; Edoardo Porto; C Arturo Solares; Gustavo Pradilla Journal: Surg Neurol Int Date: 2022-03-18