[Minimally Invasive Endoscopic Surgery: The Anterolateral Approach].

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Skull Base Surgery

Background:

• The anterolateral keyhole approach is an evolving minimally invasive technique for anterior skull base lesions.
• The supraorbital eyebrow approach provides direct frontal skull base access with cosmetic preservation and reduced morbidity.

Purpose of the Study:

• To review the anatomical concepts, indications, techniques, and limitations of the supraorbital eyebrow approach.
• To discuss complementary mini-pterional and extended-eyebrow approaches for expanded surgical fields.
• To emphasize critical aspects like CSF drainage, instrument choice, and endoscope positioning.

Main Methods:

• Review of anatomical considerations for the supraorbital eyebrow approach.
• Discussion of surgical indications and technical nuances.
• Analysis of complementary techniques and limitations.

Main Results:

• The supraorbital eyebrow approach allows direct access to the frontal skull base.
• Complementary techniques expand the operative field for lateral and Sylvian regions.
• Minimally invasive approaches require equivalent surgical efficacy to standard craniotomy.

Conclusions:

• The anterolateral keyhole approach is a safe and effective extension of cranial surgery when applied appropriately.
• Careful patient selection, anatomical knowledge, and stepwise experience are crucial for surgeons.
• Management of complications in restricted fields requires specific consideration.