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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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The importance of intra-operative endoscopic visualization performing supraorbital craniotomy

Bedeutung der endoskopischen intraoperativen Bildgebung bei Durchführung eines supraorbitalen Zuganges

Meeting Abstract

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  • corresponding author Robert Reisch - Neurochirurgische Universitätsklinik, Mainz
  • I. Gawish - Neurochirurgische Universitätsklinik, Mainz
  • A. Perneczky - Neurochirurgische Universitätsklinik, Mainz

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.11.03

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0109.shtml

Published: April 23, 2004

© 2004 Reisch et al.
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Outline

Text

Objective

The supraorbital approach through an eye-brow skin incision offers wide intracranial exposure treating different intracranial lesions. However, in some cases visualization of the deep seated structures becomes limited, according to the enormous loss of light through the limited size of key-hole craniotomy.

Methods

Between January 1993 and December 2002, 1013 supraorbital approaches were performed in our neurosurgical department. During this ten-year period the first and senior authors have performed 367 supraorbital craniotomies, these cases were retrospectively analyzed reviewing office charts, medical reports, and radiographs. Records were available from 343 patients allowing thorough evaluation of the pre-, intra-, and postoperative course. From the 343 patients 154 patients were operated with intracranial aneurysms, 76 with skull-base meningiomas, 36 with craniopharyngiomas, 22 with pituitary adenomas, 16 with frontotemporal lesions, 15 with deep seated brainstem lesions, 4 with arachnoidal cysts and 15 with other miscellaneous supra- or parasellar lesions. In 5 cases selective amygdalohippocampectomy was performed through the supraorbital approach.

Results

In the group of aneurysms endoscopes were used in 49 cases (32%), in the group of meningiomas in 10 cases (13%), in the group of craniopharyngiomas in 11 cases (30%), in the group of pituitary adenomas in all cases (100%), in the group of frontotemporal lesions in 3 cases (19%), in the group of deep-seated brain-stem lesions in 11 cases (73%), in the group of arachnoid cysts in all cases (100%) and in the group of different supra- or parasellar lesions in 7 cases (46%). Performing selective amygdalohippocampectomy, endoscopes were not used. During surgery, the endoscope assisted or controlled technique allowed safe intraoprative anatomical orientation and exact control of tumor removal or clipping procedure.

Conclusions

The endoscope assisted technique offered exquisite optical control through the limited supraorbital craniotomy. The use of endoscopes allowed accurate and safe surgical dissection especially in the surgery of deep-seated lesions.