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Related Experiment Video

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Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision

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Extended Supraorbital Approach with Modified Eyebrow Incision: Technical Note.

Marcos Devanir Silva da Costa¹, Douglas A Hardesty², Blake Priddy³

¹Department of Neurosurgery, Universidade Federal de São Paulo, São Paulo-SP, Brazil.

World Neurosurgery

|May 20, 2019

Summary

The extended supraorbital approach offers a minimally invasive technique for treating brain lesions near the anterior clinoid process. This modified eyebrow incision provides neurosurgeons with a valuable option for accessing anterior and middle cranial fossae pathologies.

Keywords:

Brain tumor Eyebrow incision Keyhole approach Minimally invasive Skull base Supraorbital approach

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Area of Science:

Neurosurgery
Minimally Invasive Surgical Techniques

Background:

The extended supraorbital approach is a minimally invasive variant of standard frontotemporal/pterional techniques.
It allows for lateral advancement and monitoring of frontal facial nerve branches.
This approach is valuable for treating pathologies lateral to the anterior clinoid process.

Observation:

The study utilized two cadaveric heads (formalin-fixed, silicone-injected) to detail the surgical steps.
A clinical case of a 56-year-old woman with a sphenoid wing meningioma was reviewed.
The patient presented with seizures and headaches, diagnosed via MRI.

Findings:

The extended supraorbital approach enabled a Simpson grade II tumor removal in the clinical case.
The procedure resulted in a good aesthetic outcome for the patient.
Cadaveric dissection demonstrated the feasibility and anatomical considerations of the approach.

Implications:

This minimally invasive supraorbital technique expands neurosurgical options for anterior and middle cranial fossa pathologies.
The approach can be effectively utilized with microscopy, endoscopy, or a combination of both.
It offers a valuable addition to the neurosurgeon's armamentarium for complex skull base surgeries.