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Supraorbital Keyhole Craniotomy for Clipping Cerebral Aneurysms: A Systematic Review and Meta-Analysis
Vera Ong1, Brian Faung2, Nolan J Brown3
1John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA.
World Neurosurgery
|October 8, 2022
Summary
The supraorbital keyhole approach is an effective minimally invasive technique for treating cerebral aneurysms. This method offers good clinical outcomes with a high aneurysm clipping rate.
Area of Science:
- Neurosurgery
- Vascular Surgery
Background:
- Open cerebrovascular surgery is essential for cerebral aneurysms.
- The supraorbital keyhole approach offers a less invasive alternative to the traditional pterional approach.
- This approach minimizes soft tissue dissection and cortical exposure.
Approach:
- A systematic literature review and meta-analysis were conducted following PRISMA guidelines.
- Data were extracted from PubMed, Scopus, and Web of Science.
- Key metrics included patient demographics, aneurysm characteristics, operative details, and clinical outcomes.
Key Points:
- The supraorbital keyhole approach demonstrated a 99% aneurysm clipping rate.
- Mean intraoperative rupture rate was 6.0%.
- An average of 93% of patients achieved favorable outcomes (mRS 0-2 or GOS IV-V).
Conclusions:
- The supraorbital keyhole approach is an effective strategy for cerebral aneurysm treatment.
- Despite heterogeneity in aneurysm treatment literature, this approach yields positive results.
- Further research may refine treatment protocols.
