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The extended eyebrow approach a cadaveric stepwise dissection.

Rafael Martinez-Perez1, Douglas A Hardesty1,2, Ricardo L Carrau1,2

  • 1Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, 410 W. 10th Ave., N-1049 Doan Hall, Columbus, OH, 43210, USA.

Acta Neurochirurgica
|January 10, 2020
PubMed
Summary

The extended eyebrow approach (xEBA) significantly improves surgical exposure of the sylvian fissure by modifying the standard eyebrow incision and supraorbital craniotomy. This technique enhances visualization for complex neurosurgical procedures.

Keywords:
Anterior fossaCerebral aneurysmsKeyholeMeningiomaMiddle fossaMinimally invasiveTuberculum sellae

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Area of Science:

  • Neurosurgery
  • Surgical Anatomy

Background:

  • The standard eyebrow incision supraorbital approach has limitations in Sylvian fissure exposure.
  • This restricts visualization during anterior cranial fossa surgeries.

Purpose of the Study:

  • To describe and validate an extended eyebrow approach (xEBA) for enhanced surgical exposure.
  • To detail the anatomical considerations and technical nuances of the xEBA.

Main Methods:

  • Stepwise cadaveric dissection was performed.
  • Anatomical analysis guided the description of the extended eyebrow approach (xEBA) technique.
  • Key anatomical landmarks and potential pitfalls were identified.

Main Results:

  • Extending the skin incision posteriorly and the craniotomy beneath the superior temporal line allows for proximal Sylvian dissection.
  • The extended eyebrow approach (xEBA) drastically improves surgical exposure.
  • The technique utilizes pretemporal, transylvian, and subfrontal corridors.

Conclusions:

  • The extended eyebrow approach (xEBA) is a versatile technique for anterior cranial fossa surgery.
  • xEBA provides enhanced visualization of critical neurovascular structures.
  • This approach offers a valuable alternative for improving surgical access and safety.