gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

The supraorbital craniotomy for surgical treatment of supra-and parasellar meningeomas

Der supraorbitale Zugang zur Resektion von supra- und parasellären Meningeomen

Meeting Abstract

Suche in Medline nach

  • corresponding author R. Reisch - Klinik für Neurochirurgie, Universitätsklinikum Mainz
  • A. Perneczky - Klinik für Neurochirurgie, Universitätsklinikum Mainz

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-06.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0019.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Reisch et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

The supraorbital craniotomy allows wide intracranial exposure of the deep-seated supra- and parasellar region, according to the concept of keyhole approaches.

Methods

Between Juli 1995 and June 2004, the supraorbital approach was used in our department in 1216 cases. After eyebrow skin incision and careful soft tissue dissection a limited supraorbital craniotomy was carried out with a diameter of ca. 10x15 mm. As a real frontolateral approach, the supraorbital craniotomy avoided removal of the orbital rim, lesser sphenoid wing or the zygomatic arch. During this ten years period, the authors performed 513 supraorbital craniotomies. These cases were retrospectively analyzed reviewing patient charts, medical reports, and radiographs. Records were available from 497 patients, from these patients 144 were treated with supra- and parasellar meningeomas. The tumour matrix was localized in 71 cases (49%) at the anterior clinoid process, in 59 cases (41%) at the planum sphenoidale and in 14 cases (10%) at the dorsum sellae. Preoperatively, the tumour caused visual field defects in 86 cases (60%), eye-movement disturbances in 23 cases (16%), pituitary malfunction in 6 cases (4%).

Results

In every case, the limited supraorbital craniotomy allowed sufficient surgical approach to the suprasellar region, an enlargement of the craniotomy was not necessary. Three months postoperatively, MRI showed in 132 cases (92%) complete, in 9 cases (6%) subtotal and in 3 cases (2%) partial tumour removal. Three months after surgery, visual improvement was recorded in 67 of 86 cases (78%), visual impairment in 11 of 144 cases (8%). The preoperative diplopia showed regeneration in 14 of 23 cases (61%), impairment was recorded in 6 of 144 cases (4%). Patients with pituitary disturbances did not show postoperative hormonal recovery, additional hormonal disturbances were recorded in 3 of 144 cases (2%).

Conclusions

The minimally invasive, limited supraorbital craniotomy offers adequate surgical exposure and acceptable postoperative results with minimal brain retraction without approach-related complications. In addition, the short skin incision within the eyebrow, careful soft tissue dissection and limited craniotomy result in a pleasing cosmetic outcome after surgery.