Lateral supraorbital approach as an alternative to the classical pterional approach

Hernesniemi, Juha; Ishii, Keisuke; Niemelä, Mika; Smrčka, Martin; Kivipelto, Leena; Fujiki, Minoru; Shen, Huiyong

doi:10.1007/3-211-27911-3_4

Cited by 186 publications

(122 citation statements)

References 4 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…The neurosurgical advantages of limited approaches are well known. 4,8,9,11,14,17 A supraorbital craniotomy through an eyebrow incision can provide a more direct approach to pathological conditions and can reduce the time from skin incision to durotomy to approximately 15 minutes, providing the potential for shorter operating times. 26 Moreover, the smaller skin incision, limited soft-tissue dissection, and minimal brain exposure and retraction can reduce associated postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Patients' cosmetic satisfaction, pain, and functional outcomes after supraorbital craniotomy through an eyebrow incision

Reisch

Marcus

Hugelshofer

et al. 2014

JNS

View full text Add to dashboard Cite

Object The supraorbital approach through an eyebrow incision offers the opportunity to access a wide variety of lesions of the anterior, middle, and even the posterior fossa. The minimally invasive keyhole craniotomy limits brain exploration and retraction and offers the potential for improved surgical outcomes and reduced approach-related complications. Patient satisfaction, however, has not yet been reported in the literature. Methods From January 2002 through December 2011, the lead author (R.R.) used a supraorbital approach through an eyebrow incision for 418 patients with cerebral aneurysms, brain tumors or cystic lesions, and other miscellaneous pathological conditions. For 408 of these patients, a detailed retrospective case note review was conducted to extract data on surgical outcomes and complications, and 375 patients completed a follow-up patient satisfaction questionnaire. Results During the early perioperative period, 8 patients died (overall mortality rate 2.0%). Among patients surveyed, the overall level of satisfaction was high. Patients rated pain from the scar and headache on a scale from 1 to 5 (1 = no pain, 5 = severe pain) as follows: pain was a score of 1 for 289 patients (77.0%), 2 for 46 (12.3%), 3 for 22 (5.9%), 4 for 12 (3.2%), and 5 for 6 (1.6%). Patients also rated cosmetic outcome on a scale from 1 to 5 (1 = very pleasant, 5 = very unpleasant) as follows: outcome was a score of 1 for 315 patients (84.0%), 2 for 33 (8.8%), 3 for 14 (3.7%), 4 for 10 (2.7%), and 5 for 3 (0.8%). Postoperative chewing difficulty was reported for 8 patients (8 [2.1%] temporary, 0 permanent); palsy of the frontal muscle for 21 patients (5.6%; 13 [3.5%] temporary, 8 [2.1%] permanent); frontal hypesthesia for 31 patients (8.3%; 18 [4.8%] temporary, 13 [3.4%] permanent); and hyposmia for 11 patients (2.9%; 3 [0.8%] temporary, 8 [2.1%] permanent). Conclusions The supraorbital approach to the anterior, middle, and posterior fossae through an eyebrow incision offers a favorable rate of approach-associated surgical complications and high patient satisfaction with cosmetic outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Patients' cosmetic satisfaction, pain, and functional outcomes after supraorbital craniotomy through an eyebrow incision

Reisch

Marcus

Hugelshofer

et al. 2014

JNS

View full text Add to dashboard Cite

show abstract

“…Various approaches, such as the lateral supraorbital approach, supraorbital keyhole surgery, and mini-pterional approach were also developed [3][4][5]. The most important goals of these surgical approaches are to minimize the brain retraction, to reduce the skin incision line associated cosmetic problems, to obtain a proper small size of bone flap for the operation, and to decrease the atrophy of muscles by reducing the temporal muscle manipulation.…”

Section: Discussionmentioning

confidence: 99%

A 16 Year Experience with Modified Lateral Supraorbital Approach for Ruptured Cerebral Aneurysms

Lim¹,

Cho²

2017

Arch Med

View full text Add to dashboard Cite

Objectives: Upto now, most authors reported the supraorbital approach for unruptured aneurysm and small and less complex aneurysm. The authors devised the Modified Lateral Supraorbital (MLSO) approach. We present a 16 year experience with MLSO approach for ruptured anterior circulation aneurysms and some parts of posterior circulation aneurysms. Materials and Methods:Aneurysm clipping surgery through the MLSO approach was performed on a total 323 patients. Baseline demographics, operative time, procedural complications, and clinical outcomes at 6 months and 1 year were retrospectively analyzed.Results: For patients treated MLSO approach, 293 had single aneurysms and 30 had multiple aneurysms. The proportion of small, medium, large, and giant aneurysms were 64% (206/323), 31% (101/323), 4.7% (15/323), and 0.3% (1/323). Mean operation time was 219.6 minutes. Procedural complications occurred in 21 cases (6.5%). Five patients died from severe brain swelling and refusal of additional treatment, while 1 patient died from tonsilar herniation due to lumbar catheter drainage. Favorable clinical outcomes, Glasgow Outcome Scale IV or V, were observed in 82.6% (267/293) and 83.6% (270/293) at 6 months and one year follow-up.The MLSO approach has the following advantages: less brain retraction, good surgical field for high positioned A-com or basilar tip aneurysm surgery, short operation time, small skin incision, minimizing temporal muscle manipulation and good cosmetic appearance. Conclusions:The MLSO approach can be considered as a useful approach for neurosurgeons for cases of general ruptured aneurysm, except those with a large amount of intracerebral hemorrhage and severe brain swelling.

show abstract

“…Hernesniemi et al 16 developed the LSOC approach through which he performed thousands of operations for anterior circulation aneurysms and tumors of the anterior fossa and sellar regions. Compared with SOC, it is a more posteriorly located skull opening with a less subfrontal angle involving a comparatively shorter incision behind the hairline and minimal temporalis dissection.…”

Section: Lateral Supraorbital Craniotomymentioning

confidence: 99%

“…It is typically ≈3×3cm in size, much smaller than the PTC, but gives access to the Sylvian fissure, basal cisterns, lamina terminalis, and the circle of Willis. 16,17 LSOC limits access to the distal Sylvian fissure and retraction of the temporal lobe, which may be problematic with brain swelling or intracerebral hematoma.…”

Section: Lateral Supraorbital Craniotomymentioning

confidence: 99%

Minimally Invasive Microsurgery for Cerebral Aneurysms

Wong

Tymianski

Radovanović

et al. 2015

Stroke

View full text Add to dashboard Cite

Lateral supraorbital approach as an alternative to the classical pterional approach

Cited by 186 publications

References 4 publications

Patients' cosmetic satisfaction, pain, and functional outcomes after supraorbital craniotomy through an eyebrow incision

Patients' cosmetic satisfaction, pain, and functional outcomes after supraorbital craniotomy through an eyebrow incision

A 16 Year Experience with Modified Lateral Supraorbital Approach for Ruptured Cerebral Aneurysms

Minimally Invasive Microsurgery for Cerebral Aneurysms

Contact Info

Product

Resources

About