Abstract:Background:The lateral supraorbital approach (LSO) provides access to a variety of pathologies including anterior and some posterior circulation aneurysms, sellar and suprasellar lesions, and anterior fossa tumors. Technical modifications of LSO improve the surgical exposure of the skull base.Methods:We retrospectively analyzed 73 consecutive patients treated by the senior author (Juha A. Hernesniemi), at the Department of Neurosurgery, Helsinki University Hospital in Helsinki, Finland from May 2013 to October… Show more
“…Lazukova et al [ 45 ] described the modified lateral supraorbital approach which is the same as the lateral supraorbital approach except for the application of an orbitozygomatic stitch.…”
Section: Resultsmentioning
confidence: 99%
“…The second type of incision is curvilinear in shape and is either behind the hairline of the temporal fossa and forehead, on the hairline, or slightly anterior. There are 28 articles [ 2 , 7 , 8 , 12 , 15 , 17 , 22 , 31 , 32 , 35 , 36 , 39 – 43 , 45 , 51 , 58 – 60 , 70 , 75 , 77 – 79 , 81 , 85 ] that describe this type of skin incision. Two articles [ 3 , 38 ] describe a bicoronal incision, one article [ 53 ] describes question mark/hockey stick incision over the temporal fossa and forehead and another article [ 55 ] describes a W-shaped incision.…”
Section: Resultsmentioning
confidence: 99%
“…Eight articles [ 1 , 6 , 20 , 25 , 31 , 38 , 48 , 79 ] described a craniotomy that involved removing bone from the fronto-spheno-zygomatic area (dark blue). Nine articles [ 8 , 14 , 36 , 45 , 55 , 57 , 60 , 82 , 83 ] described a craniotomy that involved removing bone from the fronto-sphenoidal area (pink). Five articles [ 10 , 43 , 64 , 72 , 74 ] described a craniotomy involving only frontal bone (yellow).…”
Background
The pterional or frontosphenotemporal craniotomy has stood the test of time and continues to be a commonly used method of managing a variety of neurosurgical pathology. Already described in the beginning of the twentieth century and perfected by Yasargil in the 1970s, it has seen many modifications. These modifications have been a normal evolution for most neurosurgeons, tailoring the craniotomy to the patients’ specific anatomy and pathology. Nonetheless, an abundance of variations have appeared in the literature.
Methods
A search strategy was devised according to the 2020 Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) statement. To identify articles investigating the variations in the pterional approach, the following search terms were applied: (pterional OR minipterional OR supraorbital) AND (approach OR craniotomy OR technique).
Results
In total, 3552 articles were screened with 74 articles being read in full with 47 articles being included for review. Each article was examined according the name of the technique, temporalis dissection technique, craniotomy technique and approach.
Conclusion
This systematic review gives an overview of the different techniques and modifications to the pterional craniotomy since it was initially described. We advocate for the use of a more standardised nomenclature that focuses on the target zone to simplify the management approach to supratentorial aneurysms.
“…Lazukova et al [ 45 ] described the modified lateral supraorbital approach which is the same as the lateral supraorbital approach except for the application of an orbitozygomatic stitch.…”
Section: Resultsmentioning
confidence: 99%
“…The second type of incision is curvilinear in shape and is either behind the hairline of the temporal fossa and forehead, on the hairline, or slightly anterior. There are 28 articles [ 2 , 7 , 8 , 12 , 15 , 17 , 22 , 31 , 32 , 35 , 36 , 39 – 43 , 45 , 51 , 58 – 60 , 70 , 75 , 77 – 79 , 81 , 85 ] that describe this type of skin incision. Two articles [ 3 , 38 ] describe a bicoronal incision, one article [ 53 ] describes question mark/hockey stick incision over the temporal fossa and forehead and another article [ 55 ] describes a W-shaped incision.…”
Section: Resultsmentioning
confidence: 99%
“…Eight articles [ 1 , 6 , 20 , 25 , 31 , 38 , 48 , 79 ] described a craniotomy that involved removing bone from the fronto-spheno-zygomatic area (dark blue). Nine articles [ 8 , 14 , 36 , 45 , 55 , 57 , 60 , 82 , 83 ] described a craniotomy that involved removing bone from the fronto-sphenoidal area (pink). Five articles [ 10 , 43 , 64 , 72 , 74 ] described a craniotomy involving only frontal bone (yellow).…”
Background
The pterional or frontosphenotemporal craniotomy has stood the test of time and continues to be a commonly used method of managing a variety of neurosurgical pathology. Already described in the beginning of the twentieth century and perfected by Yasargil in the 1970s, it has seen many modifications. These modifications have been a normal evolution for most neurosurgeons, tailoring the craniotomy to the patients’ specific anatomy and pathology. Nonetheless, an abundance of variations have appeared in the literature.
Methods
A search strategy was devised according to the 2020 Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) statement. To identify articles investigating the variations in the pterional approach, the following search terms were applied: (pterional OR minipterional OR supraorbital) AND (approach OR craniotomy OR technique).
Results
In total, 3552 articles were screened with 74 articles being read in full with 47 articles being included for review. Each article was examined according the name of the technique, temporalis dissection technique, craniotomy technique and approach.
Conclusion
This systematic review gives an overview of the different techniques and modifications to the pterional craniotomy since it was initially described. We advocate for the use of a more standardised nomenclature that focuses on the target zone to simplify the management approach to supratentorial aneurysms.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
