Supraorbital Keyhole Approach: Lessons Learned from 106 Operative Cases

Umit Eroglu, Kushal Shah, Melih Bozkurt, Gokmen Kahilogullari, Fatih Yakar, İhsan Dogan, Onur Ozgural, Ayhan Attar, Agahan Unlu, Sükrü Caglar, Aaron Cohen-Gadol, Hasan Caglar Ugur

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: The supraorbital keyhole approach through an eyebrow incision has been a potentially less invasive approach as an alternative to the standard pterional craniotomy. We aimed to review procedures for anterior and middle cranial fossa lesions and identify lessons learned from addressing various pathologies through this approach. Methods: We retrospectively reviewed 106 consecutive patients who underwent this approach. We documented patients’ age, sex, pathology, clinical results, extent of tumor resection, complications, use of endoscope, and cosmetic results. Results: Our series addressed a variety of pathologies. Male patients accounted for 55% of the cohort and mean age was 51.7 (2–79) years. Notably, 52% of patients underwent resection of extra-axial masses. Gross total resection was achieved in 74.4% of intra-axial lesions according to postoperative imaging. Two (1.9%) patients developed transient ptosis. One (0.9%) patient developed an allergic reaction to titanium. No cerebrospinal fluid fistula or rhinorrhea occurred. Three patients developed temporary diabetes insipidus after resection of parasellar lesions (2 craniopharyngiomas and 1 pituitary adenoma). In 14 patients with olfactory groove meningiomas, 6 (42.8%) suffered from absence or diminished olfaction postoperatively, and 2 (14.2%) developed postoperative anosmia. Five (38.5%) patients underwent a subsequent resection of recurrent glial tumors. Four weeks postoperatively, 95% of patients demonstrated acceptable cosmetic results. Cosmetic results for 6 (5%) patients were unavailable. Conclusions: The supraorbital keyhole approach may be safely used for various lesions within the anterior and middle cranial fossa. The effectiveness and limitations of this approach and possible complications are discussed. This is a valuable approach for selected patients.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StatePublished - Jan 1 2019

Fingerprint

Anterior Cranial Fossa
Cosmetics
Middle Cranial Fossa
Cerebrospinal Fluid Rhinorrhea
Olfaction Disorders
Pathology
Eyebrows
Craniopharyngioma
Diabetes Insipidus
Clinical Pathology
Smell
Craniotomy
Endoscopes
Pituitary Neoplasms
Meningioma
Titanium
Neuroglia
Fistula
Cerebrospinal Fluid
Neoplasms

Keywords

  • Aneurysm
  • Anterior skull base
  • Eyebrow incision
  • Meningioma
  • Minimally invasive
  • Supraorbital keyhole

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Eroglu, U., Shah, K., Bozkurt, M., Kahilogullari, G., Yakar, F., Dogan, İ., ... Ugur, H. C. (2019). Supraorbital Keyhole Approach: Lessons Learned from 106 Operative Cases. World Neurosurgery. https://doi.org/10.1016/j.wneu.2018.12.188

Supraorbital Keyhole Approach : Lessons Learned from 106 Operative Cases. / Eroglu, Umit; Shah, Kushal; Bozkurt, Melih; Kahilogullari, Gokmen; Yakar, Fatih; Dogan, İhsan; Ozgural, Onur; Attar, Ayhan; Unlu, Agahan; Caglar, Sükrü; Cohen-Gadol, Aaron; Ugur, Hasan Caglar.

In: World Neurosurgery, 01.01.2019.

Research output: Contribution to journalArticle

Eroglu, U, Shah, K, Bozkurt, M, Kahilogullari, G, Yakar, F, Dogan, İ, Ozgural, O, Attar, A, Unlu, A, Caglar, S, Cohen-Gadol, A & Ugur, HC 2019, 'Supraorbital Keyhole Approach: Lessons Learned from 106 Operative Cases', World Neurosurgery. https://doi.org/10.1016/j.wneu.2018.12.188
Eroglu, Umit ; Shah, Kushal ; Bozkurt, Melih ; Kahilogullari, Gokmen ; Yakar, Fatih ; Dogan, İhsan ; Ozgural, Onur ; Attar, Ayhan ; Unlu, Agahan ; Caglar, Sükrü ; Cohen-Gadol, Aaron ; Ugur, Hasan Caglar. / Supraorbital Keyhole Approach : Lessons Learned from 106 Operative Cases. In: World Neurosurgery. 2019.
@article{48af8b071c3b4709a1f67e623a8f17be,
title = "Supraorbital Keyhole Approach: Lessons Learned from 106 Operative Cases",
abstract = "Objective: The supraorbital keyhole approach through an eyebrow incision has been a potentially less invasive approach as an alternative to the standard pterional craniotomy. We aimed to review procedures for anterior and middle cranial fossa lesions and identify lessons learned from addressing various pathologies through this approach. Methods: We retrospectively reviewed 106 consecutive patients who underwent this approach. We documented patients’ age, sex, pathology, clinical results, extent of tumor resection, complications, use of endoscope, and cosmetic results. Results: Our series addressed a variety of pathologies. Male patients accounted for 55{\%} of the cohort and mean age was 51.7 (2–79) years. Notably, 52{\%} of patients underwent resection of extra-axial masses. Gross total resection was achieved in 74.4{\%} of intra-axial lesions according to postoperative imaging. Two (1.9{\%}) patients developed transient ptosis. One (0.9{\%}) patient developed an allergic reaction to titanium. No cerebrospinal fluid fistula or rhinorrhea occurred. Three patients developed temporary diabetes insipidus after resection of parasellar lesions (2 craniopharyngiomas and 1 pituitary adenoma). In 14 patients with olfactory groove meningiomas, 6 (42.8{\%}) suffered from absence or diminished olfaction postoperatively, and 2 (14.2{\%}) developed postoperative anosmia. Five (38.5{\%}) patients underwent a subsequent resection of recurrent glial tumors. Four weeks postoperatively, 95{\%} of patients demonstrated acceptable cosmetic results. Cosmetic results for 6 (5{\%}) patients were unavailable. Conclusions: The supraorbital keyhole approach may be safely used for various lesions within the anterior and middle cranial fossa. The effectiveness and limitations of this approach and possible complications are discussed. This is a valuable approach for selected patients.",
keywords = "Aneurysm, Anterior skull base, Eyebrow incision, Meningioma, Minimally invasive, Supraorbital keyhole",
author = "Umit Eroglu and Kushal Shah and Melih Bozkurt and Gokmen Kahilogullari and Fatih Yakar and İhsan Dogan and Onur Ozgural and Ayhan Attar and Agahan Unlu and S{\"u}kr{\"u} Caglar and Aaron Cohen-Gadol and Ugur, {Hasan Caglar}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.wneu.2018.12.188",
language = "English (US)",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Supraorbital Keyhole Approach

T2 - Lessons Learned from 106 Operative Cases

AU - Eroglu, Umit

AU - Shah, Kushal

AU - Bozkurt, Melih

AU - Kahilogullari, Gokmen

AU - Yakar, Fatih

AU - Dogan, İhsan

AU - Ozgural, Onur

AU - Attar, Ayhan

AU - Unlu, Agahan

AU - Caglar, Sükrü

AU - Cohen-Gadol, Aaron

AU - Ugur, Hasan Caglar

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: The supraorbital keyhole approach through an eyebrow incision has been a potentially less invasive approach as an alternative to the standard pterional craniotomy. We aimed to review procedures for anterior and middle cranial fossa lesions and identify lessons learned from addressing various pathologies through this approach. Methods: We retrospectively reviewed 106 consecutive patients who underwent this approach. We documented patients’ age, sex, pathology, clinical results, extent of tumor resection, complications, use of endoscope, and cosmetic results. Results: Our series addressed a variety of pathologies. Male patients accounted for 55% of the cohort and mean age was 51.7 (2–79) years. Notably, 52% of patients underwent resection of extra-axial masses. Gross total resection was achieved in 74.4% of intra-axial lesions according to postoperative imaging. Two (1.9%) patients developed transient ptosis. One (0.9%) patient developed an allergic reaction to titanium. No cerebrospinal fluid fistula or rhinorrhea occurred. Three patients developed temporary diabetes insipidus after resection of parasellar lesions (2 craniopharyngiomas and 1 pituitary adenoma). In 14 patients with olfactory groove meningiomas, 6 (42.8%) suffered from absence or diminished olfaction postoperatively, and 2 (14.2%) developed postoperative anosmia. Five (38.5%) patients underwent a subsequent resection of recurrent glial tumors. Four weeks postoperatively, 95% of patients demonstrated acceptable cosmetic results. Cosmetic results for 6 (5%) patients were unavailable. Conclusions: The supraorbital keyhole approach may be safely used for various lesions within the anterior and middle cranial fossa. The effectiveness and limitations of this approach and possible complications are discussed. This is a valuable approach for selected patients.

AB - Objective: The supraorbital keyhole approach through an eyebrow incision has been a potentially less invasive approach as an alternative to the standard pterional craniotomy. We aimed to review procedures for anterior and middle cranial fossa lesions and identify lessons learned from addressing various pathologies through this approach. Methods: We retrospectively reviewed 106 consecutive patients who underwent this approach. We documented patients’ age, sex, pathology, clinical results, extent of tumor resection, complications, use of endoscope, and cosmetic results. Results: Our series addressed a variety of pathologies. Male patients accounted for 55% of the cohort and mean age was 51.7 (2–79) years. Notably, 52% of patients underwent resection of extra-axial masses. Gross total resection was achieved in 74.4% of intra-axial lesions according to postoperative imaging. Two (1.9%) patients developed transient ptosis. One (0.9%) patient developed an allergic reaction to titanium. No cerebrospinal fluid fistula or rhinorrhea occurred. Three patients developed temporary diabetes insipidus after resection of parasellar lesions (2 craniopharyngiomas and 1 pituitary adenoma). In 14 patients with olfactory groove meningiomas, 6 (42.8%) suffered from absence or diminished olfaction postoperatively, and 2 (14.2%) developed postoperative anosmia. Five (38.5%) patients underwent a subsequent resection of recurrent glial tumors. Four weeks postoperatively, 95% of patients demonstrated acceptable cosmetic results. Cosmetic results for 6 (5%) patients were unavailable. Conclusions: The supraorbital keyhole approach may be safely used for various lesions within the anterior and middle cranial fossa. The effectiveness and limitations of this approach and possible complications are discussed. This is a valuable approach for selected patients.

KW - Aneurysm

KW - Anterior skull base

KW - Eyebrow incision

KW - Meningioma

KW - Minimally invasive

KW - Supraorbital keyhole

UR - http://www.scopus.com/inward/record.url?scp=85061258351&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061258351&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2018.12.188

DO - 10.1016/j.wneu.2018.12.188

M3 - Article

AN - SCOPUS:85061258351

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -