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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

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Advantages and limits of the supraorbital keyhole approach for supra-, para- and retrosellar lesions

Möglichkeiten und Grenzen der supraorbitalen Minikraniotomie bei supra-, para- und retrosellären Prozessen

Meeting Abstract

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  • corresponding author N. J. Hopf - Neurochirurgische Klinik, Katharinenhospital, Klinikum Stuttgart
  • M. Nadji-Ohl - Neurochirurgische Klinik, Katharinenhospital, Klinikum Stuttgart
  • H. Opitz - Neurochirurgische Klinik, Katharinenhospital, Klinikum Stuttgart

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.-06.02

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0017.shtml

Published: May 4, 2005

© 2005 Hopf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Supra-, para- und retrosellar lesions require distinguished planning of localization and size of the craniotomy as well as necessity of additional technical tools such as neuronavigation, intraoperative imaging or endoscopy. This study demonstrates advantages and limits of the fronto-latero-basal approach in terms of a keyhole craniotomy via an eye brow incision for such lesions.

Methods

Between 2/2003 and 12/2004 we performed supraorbital keyhole approaches in 51 patients with supra-, para- or retrosellar lesions. Lesions consisted of vascular malformations in 34 patients (30 aneurysms, 2 AVM´s, 2 cavernomas) and tumours in 17 patients (6 meningeomas, 5 gliomas, 2 craniopharyngeomas, 2 epidermoids, 2 pituitary adenomas). In 11 patients, neuronavigation, and in 14 patients, endoscopy was used. The supraorbital craniotomy was performed in prone position through a 4 cm skin incision in the eye brow with an average diameter of 2x3 cm.

Results

All lesions could be sufficiently approached using the described supraorbital keyhole craniotomy. Limits were extension of the lesion into the temporo-polar region or the third ventricle. 2 patients with CSF fistulas due to opening of the frontal sinus required a second surgical treatment.

Conclusions

The supraorbital keyhole craniotomy was found to be sufficient for a variety of supra-, para- and retrosellar lesions. Limits were extension of the lesion into the temporo-polar region or the third ventricle. Additional technical tools such as neuronavigation, intraoperative ultrasound and endoscopy were found to be helpful in tumours in order to achieve optimal control and complete resection of the lesion.