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The Supraorbital Keyhole Approach.

Necati Tatarli1, Davut Ceylan, Aşkin Şeker

  • 1*Department of Neurosurgery, Dr. Lütfi Kirdar Kartal Education and Research Hospital, Istanbul †Department of Neurosurgery, Sakarya University School of Medicine, Sakarya ‡Department of Neurosurgery, Marmara University School of Medicine §Department of Neurosurgery Education and Research Hospital ||Department of Anatomy, Koç University School of Medicine ¶Department of Neurosurgery, Bahçeşehir University School of Medicine, Istanbul, Turkey.

The Journal of Craniofacial Surgery
|June 27, 2015
PubMed
Summary

The supraorbital keyhole approach allows endoscopic and microscopic visualization of anterior cranial fossa structures. This anatomical study defines an optimal craniotomy for minimally invasive neurosurgery.

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Area of Science:

  • Neurosurgery
  • Anatomy
  • Minimally Invasive Surgery

Background:

  • The supraorbital keyhole approach offers a minimally invasive corridor to the anterior and middle cranial fossae.
  • Understanding the precise anatomical landmarks and optimal craniotomy is crucial for successful surgical navigation.

Purpose of the Study:

  • To demonstrate the anatomical structures visualized via the supraorbital keyhole approach (endoscopic and microscopic).
  • To define an optimal craniotomy for supraorbital keyhole surgery.
  • To measure key anatomical distances relevant to the approach.

Main Methods:

  • Anatomical dissection of 5 adult cadavers using the supraorbital keyhole approach.
  • Endoscopic and microscopic documentation of each surgical step.
  • Measurement of the distance between the superior temporal line and supraorbital notch/foramen in cadavers and autopsies.

Main Results:

  • The supraorbital keyhole approach provides visualization of anterior cranial fossa tumors and aneurysms.
  • Average distances between the superior temporal line and supraorbital notch/foramen were recorded in males and females.
  • No significant differences in these measurements were found between sexes or sides.

Conclusions:

  • The supraorbital keyhole craniotomy approach enables access to anterior and middle cranial fossa structures.
  • This approach facilitates adequate exposure with minimal brain retraction and a small craniotomy size.
  • It represents a viable minimally invasive technique for neurosurgical procedures.