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58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

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The supraorbital approach – a minimally invasive new approach to the superior orbit

Der supraorbitale Zugang als neuer minimal invasiver Zugangsweg zur oberen Orbita

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  • corresponding author U. Schick - Wedau Kliniken, Klinik für Neurochirurgie, Duisburg
  • W. Hassler - Wedau Kliniken, Klinik für Neurochirurgie, Duisburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocDO.04.06

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc033.shtml

Published: April 11, 2007

© 2007 Schick 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

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Objective: We present a new approach to the superior orbit via an eyebrow incision with a small osteotomy, minimal orbital rim resection and frontal trepanation. This approach was performed on 20 patients with well-defined intra- and extraconal lesions superior to the optic nerve, who underwent surgery between 2000 and 2006.

Methods: A 4-cm skin incision is performed along the brow and the supraorbital nerve is dissected. An osteotomy of the middle part of the supraorbital rim is performed using a reciprocating saw. Miniplates are fitted on both sides of the orbital rim. A small 2x3 cm frontobasal osteoclastic trepanation is then carried out. The basal dura of the frontal lobe is pushed away and the orbital roof is removed. Finally, the periorbita is closed with a dural patch and fixed with fibrin glue. The orbital rim is replaced and fixed by miniosteosynthesis. The frontobasal trepanation is filled with polymethyl-meterylate.

Results: Predominantly cavernomas, venous anomalies, schwannomas and mucoceles were operated via this new approach. The size of the lesion is not a limiting factor. This approach is purely extradural with minimal brain and orbital retraction. The only disadvantage remains a residual hypaesthetic frontal area.

Conclusions: This approach presents a new combination of an extra- and transcranial approach with excellent clinical and cosmetic results.