Supraorbital Keyhole Approach: Lessons Learned from 106 Operative Cases

Eroğlu, Ümit; Shah, Kushal; Bozkurt, Melih; Kahiloğulları, Gökmen; Yakar, Fatih; Doğan, İhsan; Özgüral, Onur; Attar, Ayhan; Ünlü, Ağahan; Çağlar, Şükrü; Cohen-Gadol, Aaron; Ugur, Hasan Çağlar

doi:10.1016/j.wneu.2018.12.188

Cited by 51 publications

(36 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Eyelid ptosis-drooping of the upper eyelid-can be due to disruption of the levator palpebrae superioris muscle-levator aponeurosis complex by tumor, by surgery, or as a result of prolonged eyelid edema. [1][2][3]5,6 The levator originates on the superomedial periorbita near the orbital apex, and may be injured during drilling or surgical dissection in a superior approach to the orbit. The third cranial nerve (CN III) can be injured in the orbit or brain, causing a neurogenic type of lid droop.…”

Section: Eyelid Malposition Pathophysiologymentioning

confidence: 99%

“…Widely reported issues include eyelid malposition including blepharoptosis and lagophthalmos, diplopia, contour abnormalities from temporalis atrophy or burr holes, enophthalmos, and hair loss. [1][2][3][4] In this article, the medical and surgical options for managing functional and aesthetic abnormalities following surgical treatment in and around the orbit are discussed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Putting the Pieces Back Together: Optimizing Function and Appearance after Orbital Surgery

Cockerham

Laplant

2021

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

Objectives To describe medical and surgical options and techniques for functional and aesthetic abnormalities after orbital surgery and multidisciplinary approaches that include the orbit. Design A review of current management options in outpatient clinics and ambulatory surgery centers with selected illustrative cases. The rationale for choosing specific medical and surgical interventions will be discussed with a focus on eyelid malposition and double vision. Setting Outpatient clinics and ambulatory surgery centers. Participants Patients with eyelid, orbital, eye muscle, and scalp contour abnormalities as a result of medical and surgical interventions for brain and/or orbital tumors. Main Outcome Measures Descriptive outcomes. Results A variety of medical and surgical options are available to optimize eyelid, orbit, extraocular muscle, and scalp structure and function.

show abstract

Section: Eyelid Malposition Pathophysiologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Putting the Pieces Back Together: Optimizing Function and Appearance after Orbital Surgery

Cockerham

Laplant

2021

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

show abstract

“…With increasing experience in skull base surgery, the concept of minimally invasive keyhole approaches flourished, intended not only as limited cranial opening but also as limited approach-associated surgical morbidity, achieved with less traumatism over the brain [45] . The supraorbital route and a series of its modifications (the supraorbital eyebrow incision approach, the mini-supraorbital keyhole craniotomy, the transciliary approach, and the lateral supraorbital approach) epitomized the reconciliation of both concepts, benefiting from the tenets of minimal, efficacious access of keyhole approaches and those of maximal, effective, atraumatic brain exposures from skull base [46][47][48] .…”

Section: Endoscope-assisted Surgerymentioning

confidence: 99%

Meningiomas: criteria for modern surgical indications

Cappabianca¹,

d’Avella²,

Cavallo³

et al. 2020

Mini-invasive Surg

View full text Add to dashboard Cite

The contemporary management of meningiomas is the result of the continuous evolution of neurosurgical techniques, along with the refinement of dedicated instrumentations. Above all, it is the magnification of the surgical view, thanks to the microscope and the endoscope, and their advancements, which allowed the improvement of surgical outcomes, in terms of both extent of resection and morbidity rates. Because of the benign nature of the vast majority of meningiomas, complete tumor resection is curative, and it is the gold-standard treatment. However, in the case of high risk of surgical morbidity, a less aggressive surgical treatment may be justified, also upon tailored analysis of the meningiomas’ biological behavior and the improvements in postoperative strategies. The endoscopic technique plays a role, as a unique visualization tool or in combination with the microscope, in granting so-called maximum allowed resection. Considering the above, the most challenging task confronting modern meningioma surgery remains the selection of the most appropriate surgical approach, the latter greatly depending on location, anatomic tumor features, and relationships with critical neurovascular structures. Herein, we present a cogent analysis of the modern multifaceted indications for the endoscopic treatment of meningiomas, with a glimpse into the adjacent fields.

show abstract

“…The skin incision can be made completely within the eyebrow, allowing for excellent functional and cosmetic outcomes. [3][4][5][6] It has become an effective, versatile, and minimally invasive approach with many advantages for lesions of the anterior skull base compared with a standard pterional craniotomy. Those advantages include a smaller incision, less temporalis muscle dissection, low risk of damage to the frontalis branch of the facial nerve, an anterior to posterior operative trajectory, and no fixed brain retraction is needed.…”

Section: Introductionmentioning

confidence: 99%

“…Commonly cited complications related to this approach include pseudomeningocele, CSF leak, supraorbital hypesthesia, and infection. [3][4][5][6] Descriptions of this approach frequently mention the importance of taking care to avoid the frontal sinus to limit the risk of CSF leak, infection, and mucocele. [1][2][3]6 However, unintentional breach of the frontal sinus often occurs.…”

Section: Introductionmentioning

confidence: 99%

Orbitozygomatic Craniotomy via an Eyebrow Incision: Management of the Opened Frontal Sinus

Peters

Payne²,

Wait

2020

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

Background The eyebrow orbitozygomatic craniotomy is a minimally invasive approach that can access a wide variety of lesions. Unintentional breach of the frontal sinus frequently occurs and has been cited as a reason to avoid this approach. Lack of access to a large pericranial graft and the inability to completely cranialize the sinus requires alternate techniques of sinus repair. We describe a technique for repairing an opened frontal sinus and retrospectively reviewed complications related to this approach. Methods All patients, who underwent an orbitozygomatic craniotomy via an eyebrow incision by a single surgeon from August 1, 2012 to August 31, 2018, were included in this retrospective analysis. Data were collected on patient demographics, pathology treated, operative details, and perioperative morbidity. Follow-up ranged from 6 weeks to 6 years. Results Total 50 patients with a wide variety of pathologies underwent analysis. Frontal sinus breach occurred in 21 patients. All were repaired by the described technique. One patient (ruptured aneurysm) had a suspected cerebrospinal fluid (CSF) leak postoperatively that resolved without any additional intervention. One patient developed a pneumomeningocele 4 years postoperatively that required reoperation. No patient suffered any infection or delayed CSF leak. Conclusion Breach of the frontal sinus is common during eyebrow craniotomies. Despite reduced options for local repair, these patients have experienced no CSF leaks requiring intervention and no infections in our series. Long-term mucocele risk is not reliably determined with our length of follow-up. Breach of the frontal sinus is not a contraindication to the eyebrow approach.

show abstract

Supraorbital Keyhole Approach: Lessons Learned from 106 Operative Cases

Cited by 51 publications

References 18 publications

Putting the Pieces Back Together: Optimizing Function and Appearance after Orbital Surgery

Putting the Pieces Back Together: Optimizing Function and Appearance after Orbital Surgery

Meningiomas: criteria for modern surgical indications

Orbitozygomatic Craniotomy via an Eyebrow Incision: Management of the Opened Frontal Sinus

Contact Info

Product

Resources

About