Document Detail


Eyelid approach to the anterior cranial base.
MedLine Citation:
PMID:  18671651     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Skull base approaches play a fundamental role in modern neurosurgery by reducing surgical morbidity. Increasing experience has allowed surgeons to perform minimally invasive approaches without straying from the premises of skull base surgery. The eyelid approach has evolved from the orbitopterional osteotomy into a more effective and targeted approach to disease of the anterior cranial fossa. In this technique, after an incision is made on the supratarsal fold, the orbicularis oculi muscle is incised, and a myocutaneous flap composed of the elements of the anterior lamella is elevated. Subperiosteal dissection is used to expose the superior and lateral walls of the orbit, the superior and lateral orbital rim, and the frontosphenoidal suture. A MacCarty bur hole is drilled, and a frontal osteotomy is fashioned medial to the supraorbital notch and extending through the orbital roof back toward the orbital half of the MacCarty bur hole, exposing the frontobasal brain. A conventional microsurgical technique is used to treat tumors and aneurysms of the anterior cranial fossa under the operative microscope. Five patients were treated for unruptured aneurysms of the anterior circulation (3 anterior communicating artery aneurysms, 1 ophthalmic artery aneurysm, and 1 posterior communicating artery aneurysm) using the eyelid approach. The mean aneurysm size was 5 mm, and all aneurysms were approached from the right side. Three tumors in the anterior fossa (2 suprasellar pituitary adenomas and 1 craniopharyngioma) were also excised using this approach. There was no surgical morbidity. Three months after surgery all patients presented excellent cosmetic results. The eyelid approach may be considered as an effective, cosmetically beneficial, and minimally invasive skull base approach to selected aneurysms and tumors of the anterior circulation.
Authors:
Norberto Andaluz; Alberto Romano; Likith V Reddy; Mario Zuccarello
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  109     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-01     Completed Date:  2008-09-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  341-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, University of South Florida, Tampa, Florida, USA. nandaluz@hsc.usf.edu
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MeSH Terms
Descriptor/Qualifier:
Adenoma / surgery
Craniopharyngioma / surgery
Eyelids / surgery*
Female
Humans
Intracranial Aneurysm / surgery*
Male
Middle Aged
Neurosurgical Procedures*
Ophthalmic Artery
Orbit / surgery
Pituitary Neoplasms / surgery
Skull Base / surgery*
Surgical Procedures, Minimally Invasive*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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