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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
A superciliary approach for anterior cranial fossa lesions in children. Technical note
George I Jallo1, Ian Suk, László Bognár
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. gjallo1@jhmi.edu
Insights
The frontolateral keyhole craniotomy is a safe and effective surgical approach for treating pediatric anterior cranial fossa lesions. This minimally invasive technique offers a viable alternative for various intracranial conditions in children.
Area of Science:
- Neurosurgery
- Pediatric Neurosurgery
- Surgical Techniques
Background:
- Subfrontal and orbitofrontal craniotomies are established methods for anterior cranial fossa lesions.
- The frontolateral keyhole craniotomy offers a modified, minimally invasive approach.
Purpose of the Study:
- To evaluate the surgical experience with the frontolateral keyhole craniotomy in pediatric patients.
- To assess the safety and efficacy of this approach for anterior cranial fossa and suprasellar lesions in children.
Main Methods:
- A retrospective review of 28 procedures performed on 27 children (ages 1-16).
- Utilized a keyhole craniotomy with a 2.5 x 3-cm bone opening via a superciliary incision.
- The approach was applied to treat arachnoid cysts, cerebrospinal fluid fistulas, and tumors.
Main Results:
- The frontolateral keyhole craniotomy was successfully employed in 28 procedures.
- The approach was found to be safe and simple for treating anterior cranial fossa and suprasellar lesions.
- No vascular lesions were treated using this method in the study cohort.
Conclusions:
- The frontolateral keyhole craniotomy is a safe and simple surgical option for pediatric anterior cranial fossa and suprasellar lesions.
- This technique provides a valuable alternative for neurosurgeons treating children with specific intracranial pathologies.
Abstract:
Many subfrontal and orbitofrontal craniotomy techniques have been proposed and developed for anterior cranial fossa lesions. The purpose of this study was to evaluate the surgical experience with the frontolateral keyhole craniotomy through a superciliary skin incision in children. The keyhole craniotomy is a modification of the traditional pterional approach. This modified approach, a craniotomy with a 2.5 x 3-cm bone opening just above the eyebrow through a superciliary incision, has been previously described in adults for many lesions situated in the anterior cranial fossa, including tumors and aneurysms. The authors review their experience in using this approach in 27 children for a variety of intracranial lesions. This approach was used for 28 procedures in children ranging in age from 1 to 16 years (mean age 10 years). The lesions included arachnoid cysts, cerebrospinal fluid fistulas, and tumors; no vascular lesions were treated. The authors have found this craniotomy to be a safe and simple approach for treating anterior cranial fossa and suprasellar lesions in children.
