scholarly journals The Supraorbital Keyhole Craniotomy through an Eyebrow Incision: Its Origins and Evolution

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
D. Ryan Ormond ◽  
Costas G. Hadjipanayis
Keyword(s):  
Review Of The Literature ◽  
Eyebrow Incision ◽  
Rigid Rod ◽  
Keyhole Approach ◽  
Subfrontal Approach ◽  
Keyhole Craniotomy ◽  
Modern Era ◽  
Anatomic Localization ◽  
Poor Lighting ◽  
Operative Microscope

In the modern era of neurosurgery, the use of the operative microscope, rigid rod-lens endoscope, and neuronavigation has helped to overcome some of the previous limitations of surgery due to poor lighting and anatomic localization available to the surgeon. Over the last thirty years, the supraorbital craniotomy and subfrontal approach through an eyebrow incision have been developed and refined to play a legitimate role in the armamentarium of the modern skull base neurosurgeon. With careful patient selection, the supraorbital “keyhole” approach offers a less invasive but still efficacious approach to a number of lesions along the subfrontal corridor. Well over 1000 cases have been reported in the literature utilizing this approach establishing its safety and efficacy. This paper discusses the nuances of this approach, including the benefits and limitations of its use described through our technique, review of the literature, and case illustration.

A Review of the Literature on the Transciliary Supraorbital Keyhole Approach

2017 ◽  
Vol 98 ◽  
pp. 614-624 ◽  
Author(s):  
Daniel Walter Zumofen ◽  
Jonathan Rychen ◽  
Michel Roethlisberger ◽  
Ethan Taub ◽  
Daniel Kalbermatten ◽  
...  
Keyword(s):  
Review Of The Literature ◽  
Keyhole Approach

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

2014 ◽  
Vol 121 (3) ◽  
pp. 730-734 ◽  
Author(s):  
Robert Reisch ◽  
Hani J. Marcus ◽  
Michael Hugelshofer ◽  
Nicolas Olmo Koechlin ◽  
Axel Stadie ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Surgical Outcomes ◽  
Cerebral Aneurysms ◽  
Perioperative Period ◽  
Cosmetic Outcome ◽  
Lead Author ◽  
Retrospective Case ◽  
Supraorbital Approach ◽  
Eyebrow Incision ◽  
Keyhole Craniotomy

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.

Ten-year Experience with the Supraorbital Subfrontal Approach through an Eyebrow Skin Incision

2005 ◽  
Vol 57 (suppl_4) ◽  
pp. ONS-242-ONS-255 ◽  
Author(s):  
Robert Reisch ◽  
Axel Perneczky
Keyword(s):  
Cerebral Aneurysms ◽  
Skin Incision ◽  
Diagnostic Tools ◽  
Soft Tissue Dissection ◽  
Scale Scores ◽  
Microsurgical Techniques ◽  
Subfrontal Approach ◽  
Brain Retraction ◽  
Keyhole Craniotomy ◽  
Supraorbital Craniotomy

Abstract OBJECTIVE: More than ever before, the priority in contemporary neurosurgery is to achieve the greatest therapeutic effect while causing the least iatrogenic injury. The evolution of microsurgical techniques with refined instrumentation and illumination and the enormous development of preoperative and intraoperative diagnostic tools enable neurosurgeons to treat different lesions through limited and specific keyhole approaches. METHODS: Based on our surgical experience, the technique of supraorbital subfrontal craniotomy is described in detail in this article. After an eyebrow skin incision is made, a limited supraorbital craniotomy is performed with a width of 15 to 25 mm and a height of 10 to 15 mm. RESULTS: We have been using the supraorbital keyhole craniotomy since 1985 and have approached a variety of lesions within the anterior, middle, and posterior cranial fossae. During a 10-year period between July 1994 and June 2004, the lesions treated via the supraorbital approach in our department comprised 1125 intracranial tumors or cystic lesions, cerebral aneurysms, and other miscellaneous diseases, performed by 23 different surgeons and residents. Of these 1125 patients, we operated on 471 of them, and information obtained from 450 contributed to the follow-up data. Three months after surgery, the Glasgow Outcome Scale scores for this very heterogeneous group of patients were as follows: 5 in 387 patients (86.0%), 4 in 29 patients (6.4%), 3 in 16 patients (3.5%), 2 in 10 patients (2.2%), and 1 in 8 patients (1.8%). Of the 450 patients, 229 were treated for intracranial aneurysms, 93 for cranial base meningiomas, 39 for craniopharyngiomas, 23 for pituitary adenomas, 18 for deep-seated brainstem tumors, and 48 for other miscellaneous frontotemporal or suprasellar lesions. CONCLUSION: In our experience, the supraorbital craniotomy allows a wide, intracranial exposure for extended, bilaterally situated, or even deep-seated intracranial areas, according to the strategy of keyhole craniotomies. The supraorbital craniotomy offers equal surgical possibilities with less approach-related morbidity owing to limited exposure of the cerebral surface and minimal brain retraction. In addition, the short skin incision within the eyebrow and careful soft tissue dissection result in a pleasing cosmetic outcome.

scholarly journals Surgical management of anterior skull base compartment tumors through an eyebrow incision and supraorbital keyhole craniotomy

2018 ◽  
Author(s):  
Jorge da Silva Lapa ◽  
Thais de Souza Melo ◽  
Augusto Esmeraldo ◽  
Carlos Pereira ◽  
Arthur Oliveira
Keyword(s):  
Skull Base ◽  
Surgical Management ◽  
Anterior Skull Base ◽  
Eyebrow Incision ◽  
Keyhole Craniotomy

scholarly journals Artificial Intelligence in Dermatopathology: New Insights and Perspectives

2021 ◽  
Vol 8 (3) ◽  
pp. 418-425
Author(s):  
Gerardo Cazzato ◽  
Anna Colagrande ◽  
Antonietta Cimmino ◽  
Francesca Arezzo ◽  
Vera Loizzi ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Differential Diagnosis ◽  
State Of The Art ◽  
The State ◽  
Embryonic Stage ◽  
Future Perspectives ◽  
Review Of The Literature ◽  
Melanocytic Lesions ◽  
Modern Era

In recent years, an increasing enthusiasm has been observed towards artificial intelligence and machine learning, involving different areas of medicine. Among these, although still in the embryonic stage, the dermatopathological field has also been partially involved, with the attempt to develop and train algorithms that could assist the pathologist in the differential diagnosis of complex melanocytic lesions. In this article, we face this new challenge of the modern era, carry out a review of the literature regarding the state of the art and try to determine promising future perspectives.

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