Robert Reisch1, Hani J Marcus, Ralf A Kockro, Nils H Ulrich. 1. Centre for Endoscopic and Minimally Invasive Neurosurgery, Clinic Hirslanden, Witellikerstr. 40, 8032, Zurich, Switzerland, robert.reisch@hirslanden.ch.
Abstract
BACKGROUND: Improvements in image guidance, endoscopy, and instruments, have significantly advanced "keyhole" neurosurgery. We describe the concept and technique of the supraorbital keyhole approach. METHODS: The supraorbital keyhole approach is performed through an eyebrow skin incision. Image guidance may be used to define the optimal surgical trajectory. A limited supraorbital craniotomy is fashioned. The frontal lobe is mobilized and the central skull base approached, without the need for brain retractors. Endoscopy is used to enhance visualization, and tube-shaft instruments to improve manipulation through the narrow surgical corridor. CONCLUSIONS: The supraorbital keyhole approach provides a safe method to access selected skull base lesions.
BACKGROUND: Improvements in image guidance, endoscopy, and instruments, have significantly advanced "keyhole" neurosurgery. We describe the concept and technique of the supraorbital keyhole approach. METHODS: The supraorbital keyhole approach is performed through an eyebrow skin incision. Image guidance may be used to define the optimal surgical trajectory. A limited supraorbital craniotomy is fashioned. The frontal lobe is mobilized and the central skull base approached, without the need for brain retractors. Endoscopy is used to enhance visualization, and tube-shaft instruments to improve manipulation through the narrow surgical corridor. CONCLUSIONS: The supraorbital keyhole approach provides a safe method to access selected skull base lesions.
Authors: Roger Neves Mathias; Stefan Lieber; Paulo Henrique Pires de Aguiar; Marcos Vinícius Calfat Maldaun; Paul Gardner; Juan C Fernandez-Miranda Journal: J Neurol Surg B Skull Base Date: 2015-11-30