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Related Experiment Video

Updated: Jun 20, 2025

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Endoscopic Eyebrow Approach for Aneurysms.

Gerrit Fischer1,2, Joachim Oertel3,4

  • 1Department of Neurosurgery, Saarland University Hospital, Homburg, Saar, Germany.

Advances and Technical Standards in Neurosurgery
|July 17, 2024
PubMed
Summary

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Neurosurgical review·2025

The supraorbital eyebrow approach, enhanced by endoscopy, improves aneurysm surgery safety and outcomes. This minimally invasive technique offers better visualization, reducing complications and improving cosmetic results for anterior circulation aneurysms.

Area of Science:

  • Neurosurgery
  • Minimally Invasive Surgery
  • Cerebrovascular Surgery

Background:

  • The supraorbital eyebrow approach, a keyhole concept in neurosurgery, aims to reduce surgical invasiveness.
  • Limited surgical approaches can complicate demanding procedures like aneurysm surgery.
  • Enhancing visualization during aneurysm surgery is crucial for improving treatment quality.

Purpose of the Study:

  • To evaluate the safety and efficacy of the supraorbital eyebrow approach for treating anterior circulation aneurysms.
  • To assess the benefits of endoscopic visualization in conjunction with the supraorbital approach.
  • To determine the impact of this combined technique on complication rates and surgical outcomes.

Main Methods:

  • Retrospective review of clinical articles on endoscopic aneurysm surgery.
Keywords:
Aneurysm clippingEndoscopic controlled surgeryEyebrow approachSupraorbital craniotomy

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  • Analysis of the supraorbital eyebrow approach's application in anterior circulation aneurysms.
  • Evaluation of endoscopic intraoperative and postoperative control in aneurysm clipping.

    • Main Results:

    • The supraorbital eyebrow approach offers access to most anterior circulation aneurysms, with contraindications for large/complex aneurysms and severe subarachnoid hemorrhage.
    • Endoscopic procedures in aneurysm surgery have shown no major complications.
    • Endoscopic inspection reduced intraoperative rupture rates and improved detection of aneurysm remnants and vessel compromise.

    Conclusions:

    • The supraorbital eyebrow approach is a safe, effective, and cosmetically favorable method for treating most anterior circulation aneurysms.
    • Endoscopic enhancement of the supraorbital approach improves visual field, potentially decreasing intraoperative ruptures and improving occlusion assessment.
    • This combined technique offers a significant advantage in managing complex cerebrovascular cases.