Supraorbital-pterional approach to skull base lesions

Area of Science:

• Neurosurgery
• Skull Base Surgery

Background:

• Skull base surgery requires optimal visualization and minimal invasiveness.
• Complex lesions in the suprasellar, parasellar, and retrosellar areas present significant surgical challenges.

Purpose of the Study:

• To describe a novel surgical approach to the skull base.
• To evaluate its efficacy in managing deep and extensive cranial base lesions.
• To present surgical outcomes and suggest indications for this approach.

Main Methods:

• A single bone flap technique is utilized.
• The approach allows for subfrontal, transsylvian, or subtemporal access.
• Minimal brain retraction is employed to access deep lesions.

Main Results:

• Excellent exposure of the cranial base was achieved.
• The approach facilitated management of large lesions in critical areas (suprasellar, parasellar, retrosellar).
• Lesions extending into the cavernous sinus, tentorial notch, or orbit were successfully addressed.
• Patients experienced minimal functional, anatomical, or cosmetic deficits post-operatively.

Conclusions:

• This surgical approach provides superior cranial base exposure with reduced brain retraction.
• It is highly suitable for complex and extensive skull base tumors.
• The technique offers excellent outcomes with minimal patient morbidity.