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

2017 ◽  
Vol 09 (01) ◽  
Author(s):  
Jaejoon Lim ◽  
Kyunggi Cho
Keyword(s):  
Cerebral Aneurysms ◽  
Supraorbital Approach ◽  
Lateral Supraorbital Approach ◽  
Modified Lateral Supraorbital Approach

The modified lateral supraorbital approach

2017 ◽  
Vol 32 (4) ◽  
pp. 418-423 ◽  
Author(s):  
Umit Kocaman ◽  
Tayfun Dalbasti ◽  
Mehmet Haluk Ozer ◽  
Hakan Yilmaz ◽  
Muhammet Bahadir Yilmaz ◽  
...  
Keyword(s):  
Supraorbital Approach ◽  
Lateral Supraorbital Approach ◽  
Modified Lateral Supraorbital Approach

Microsurgical Management of the Middle Cerebral Artery Bifurcation Aneurysms: An Anatomic Feasibility Study

ORL ◽  
2021 ◽  
pp. 1-9
Author(s):  
Ali Karadag ◽  
Baran Bozkurt ◽  
Kaan Yagmurlu ◽  
Ada Irmak Ozcan ◽  
Sean Moen ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Surgical Complications ◽  
Digital Camera ◽  
Head Rotation ◽  
Complex Aneurysms ◽  
Head Positioning ◽  
Supraorbital Approach ◽  
Lateral Supraorbital Approach ◽  
Head Positions

Background: The proper head positioning decreases the surgical complications by enabling a better surgical maneuverability. Middle cerebral artery (MCA) bifurcation aneurysms have been classified by Dashti et al. [Surg Neurol. 2007 May;67(5):441–56] as the intertruncal, inferior, lateral, insular, and complex types based on dome projection. Our aim was to identify the optimum head positions and to explain the anatomic variables, which may affect the surgical strategy of MCA bifurcation aneurysms. Methods: The lateral supraorbital approach bilaterally was performed in the 4 cadaveric heads. All steps of the dissection were recorded using digital camera. Results: The distal Sylvian fissure (SF) dissection may be preferred for insular type and the proximal SF dissection may be preferred for all other types. Fifteen degrees head rotation was found as the most suitable position for the intertruncal, lateral type and subtype of complex aneurysms related with superior trunk. Thirty degrees head rotation was found the most suitable position for the inferior type, insular type, and subtype of complex aneurysms related with inferior trunk. Conclusions: The head positioning in middle cerebral bifurcation aneurysms surgery is a critical step. It should be tailored according to the projection and its relationship with the parent vessels of the middle cerebral bifurcation.

scholarly journals The surgical approach for clipping anterior communicating artery Aneurysm

2019 ◽  
Vol 16 (1) ◽  
pp. 10-20
Author(s):  
Robin Bhattarai ◽  
Chuan Chen ◽  
Chao Feng Liang ◽  
Teng Chao Huang ◽  
Hui Wang ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Aneurysm Surgery ◽  
Pterional Approach ◽  
Supraorbital Approach ◽  
Lateral Supraorbital Approach ◽  
Eyebrow Incision ◽  
Frontal Branch

Anterior communicating artery (ACoA) aneurysm, accounts for 30%-35% of all the aneurysm making it one of the most common intracranial aneurysms. Although the Pterional approach is considered as the safe and appropriate method in ACoA aneurysm surgery, temporalis atrophy and injury to a frontal branch of the facial nerve are few inexorable complications. With the advancement of minimally invasive surgery several modified approaches, such as the supraorbital eyebrow incision approach, the minipterional approach, the mini-supraorbital approach, and the lateral supraorbital approach has been recently introduced and has been used as an alternative.

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.

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