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Home Neurosurgery Cadaver  [Cadaver] Eyebrow Keyhole Approach

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[Cadaver] Infratemporal Fossa Approach


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[Cadaver] Eyebrow Keyhole Approach
SURGFLIX_CDV 3DMediVision | Republic of Korea Speciality : 3DMV

Related Information
We report our experience with a supraorbital eyebrow minicraniotomy. This technique is suitable to lesions situated in the region of the anterior fossa, suprasellar cisterns, parasellar region and Sylvian fissure.

• Supraorbital craniotomy allows for relatively easy and rapid access to structures in the anterior cranial fossa and sellar and parasellar regions. This minimally invasive technique provides a subfrontal approach with minimal disruption of normal anatomy, excellent cosmetic results, shorter operation times and hospital stays with faster recovery, and less morbidity.

• This approach can be used to treat many different and extraaxial pathologies in or near the frontal lobes, including extraaxial lesions (i.e., anterior skull base meningiomas, craniopharyngiomas, epidural abscesses) and intraaxial lesions (i.e., gliomas, metastatic lesions) of the frontal lobe.

• The decision to use this technique versus other approaches to the frontal lobe (e.g., bicoronal or pterional craniotomy) is based on the desired anatomic and operative trajectory (i.e., subfrontal vs. anterolateral approach). The decision requires detailed preoperative examination of the location of the lesion, its relationship to other vital structures, the size of the lesion, edema and mass effect of the lesion, the planned angle of dissection, and the patient’s comorbidities and overall health.

• The supraorbital approach can be combined with an orbital osteotomy to provide additional visualization of structures and lesions above the level of the anterior communicating artery complex.

• Supraorbital craniotomy is not ideal for lesions with significant middle fossa or cavernous sinus involvement.

• Lesions with significant edema and associated hydrocephalus are relative contraindications. We have placed preoperative lumbar subarachnoid drains in situations in which the lesion may restrict early intraoperative access to the cisterns that would otherwise be fenestrated to facilitate brain manipulation.

• Superior and more posterior frontal lobe lesions are difficult to access from this approach.

• A large frontal sinus is a contraindication.

• Lesions requiring significant vascular manipulation and dissection are contraindications.

■ Microscope : CarlZeiss Vario

■ Navigation : Medtronic

■ Surgical Drill : N/A

■ 3D Camera : 3DMedivision M-Flix

■ 3D Recorder : 3DMedivision R-Flix
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