In Reply to the Letter to the Editor Regarding “Supraorbital Keyhole Craniotomy via Eyebrow Incision: A Systematic Review and Meta-Analysis”

Robinow, Zoe; Peterson, Catherine; Waldau, Ben; Shahlaie, Kiarash

doi:10.1016/j.wneu.2022.07.100

World Neurosurgery

2022

DOI: 10.1016/j.wneu.2022.07.100

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In Reply to the Letter to the Editor Regarding “Supraorbital Keyhole Craniotomy via Eyebrow Incision: A Systematic Review and Meta-Analysis”

Zoe Robinow

Catherine Peterson

Ben Waldau

et al.

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2024

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The Endoscopic Transorbital Approach for Vascular Surgery: An Anterior Circulation Anatomic Study, 2-Dimensional Operative Video

Plata-Bello,

Mosteiro-Cadaval,

Manfrellotti

et al. 2024

Operative Neurosurgery

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BACKGROUND AND OBJECTIVES: Minimally invasive endoscopic approaches in cranial base surgery have been developing in the past decades. The transorbital (TO) route is one promising alternative, yet its adequacy for intracranial vascular lesions remains unclear. The present anatomic work aimed to test the feasibility and to provide a qualitative description of the endoscopic TO approach for the anterior circulation, namely the internal carotid artery and the middle cerebral artery. METHODS: Seven embalmed adult cadaveric specimens (12 sides) were used in the study. Each side was approached in 3 successive steps: (1) Superior-eyelid TO approach, with great and lesser sphenoid wing removal. (2) Removal of anterior clinoid process (ACP). (3) Removal of the lateral orbital rim. All the procedures were performed under endoscopic view. RESULTS: The TO approach without removing the ACP allowed to dissect the sphenoidal and lateral segments of the Sylvian fissure with an adequate identification of the middle cerebral artery bifurcation in all specimens. The removal of the ACP allowed further dissection toward the opticocarotid cistern, with the identification of the ophthalmic, posterior communicating, and the anterior choroidal arteries. The internal carotid artery bifurcation and A1 segment were also readily identified. Finally, removal of the lateral orbital rim provided a wider and more comfortable access to the above-mentioned vascular structures. CONCLUSION: According to our anatomic data, the TO approach can be used to reach the main vascular components of the anterior circulation. This opens the field for exploring its application in the treatment of vascular pathology, particularly aneurysms.

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The Endoscopic Transorbital Approach for Vascular Surgery: An Anterior Circulation Anatomic Study, 2-Dimensional Operative Video

Plata-Bello,

Mosteiro-Cadaval,

Manfrellotti

et al. 2024

Operative Neurosurgery

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In Reply to the Letter to the Editor Regarding “Supraorbital Keyhole Craniotomy via Eyebrow Incision: A Systematic Review and Meta-Analysis”

Cited by 1 publication

References 4 publications

The Endoscopic Transorbital Approach for Vascular Surgery: An Anterior Circulation Anatomic Study, 2-Dimensional Operative Video

The Endoscopic Transorbital Approach for Vascular Surgery: An Anterior Circulation Anatomic Study, 2-Dimensional Operative Video

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