Supraorbital Keyhole Versus Pterional Approach: A Morphometric Anatomical Study.

Anatomical study Morphometric analysis Pterional craniotomy Supraorbital keyhole

Journal

Acta neurochirurgica. Supplement
ISSN: 0065-1419
Titre abrégé: Acta Neurochir Suppl
Pays: Austria
ID NLM: 100962752

Informations de publication

Date de publication:
2023
Historique:
medline: 28 12 2023
pubmed: 28 12 2023
entrez: 28 12 2023
Statut: ppublish

Résumé

Although the supraorbital (SO) keyhole approach has a wide range of indications, its routine usefulness with the advance of current technology has not been fully evaluated. In an attempt to address this issue, a cadaveric morphometric analysis to the supra- and parasellar regions was performed, comparing the standard Pterional craniotomy (PT) with the SO keyhole. ETOH-fixed and silicone-injected human cadaveric heads were used. SO (n = 8) and PT craniotomies (n = 8) were performed. Pre- and post-dissection CT, along with pre-dissection MRI scans were also completed for neuro-navigation purposes, aimed to verify predetermined anatomical landmarks selected for morphometric analysis. Notwithstanding the smaller craniotomy, the SO approach allowed optimal anatomical exposure when compared to the PT approach. With 30° of head rotation, the SO keyhole showed a wider surgical field of the suprasellar region. Using detailed preoperative image-guided surgical planning, the SO keyhole approach offered an appropriate alternative route to the supra- and parasellar regions, compared to the PT craniotomy.

Identifiants

pubmed: 38153459
doi: 10.1007/978-3-031-36084-8_20
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

119-123

Informations de copyright

© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.

Références

Yasargil MG, Fox JL. The microsurgical approach to intracranial aneurysms. Surg Neurol. 1975;3(1):7–14; PMID: 1111150.
pubmed: 1111150
Yasargil MG, Antic J, Laciga R, Jain KK, Hodosh RM, Smith RD. Microsurgical pterional approach to aneurysms of the basilar bifurcation. Surg Neurol. 1976;6(2):83–91; PMID: 951657.
pubmed: 951657
Schlitt M, Quindlen EA. Osteoplastic pterional craniotomy. South Med J. 1989;82(5):592–5. https://doi.org/10.1097/00007611-198905000-00012 ; PMID: 2717984.
doi: 10.1097/00007611-198905000-00012 pubmed: 2717984
de Andrade Júnior FC, de Andrade FC, de Araujo Filho CM, Carcagnolo FJ. Dysfunction of the temporalis muscle after pterional craniotomy for intracranial aneurysms. Comparative, prospective and randomized study of one flap versus two flaps dieresis. Arq Neuropsiquiatr. 1998;56(2):200–5. https://doi.org/10.1590/s0004-282x1998000200006 ; PMID: 9698728.
doi: 10.1590/s0004-282x1998000200006 pubmed: 9698728
Brock M, Dietz H. The small frontolateral approach for the microsurgical treatment of intracranial aneurysms. Neurochirurgia (Stuttg). 1978;21(6):185–91. https://doi.org/10.1055/s-0028-1090343 ; PMID: 724020.
doi: 10.1055/s-0028-1090343 pubmed: 724020
Chehrazi BB. A temporal transsylvian approach to anterior circulation aneurysms. Neurosurgery. 1992;30(6):957–61. https://doi.org/10.1227/00006123-199206000-00029 ; PMID: 1614606.
doi: 10.1227/00006123-199206000-00029 pubmed: 1614606
Harland SP, Hussein A, Gullan RW. Modification of the standard pterional approach for aneurysms of the anterior circle of Willis. Br J Neurosurg. 1996;10(2):149–53. https://doi.org/10.1080/02688699650040296 ; discussion 153. PMID: 8861305.
doi: 10.1080/02688699650040296 pubmed: 8861305
Yagmurlu K, Safavi-Abbasi S, Belykh E, Kalani MYS, Nakaji P, Rhoton AL Jr, Spetzler RF, Preul MC. Quantitative anatomical analysis and clinical experience with mini-pterional and mini-orbitozygomatic approaches for intracranial aneurysm surgery. J Neurosurg. 2017;127(3):646–59. https://doi.org/10.3171/2016.6.JNS16306 ; Epub 2016 Nov 18. PMID: 27858574.
doi: 10.3171/2016.6.JNS16306 pubmed: 27858574
Gonçalves DB, Dos Santos MIA, de Cristo Rojas Cabral L, Oliveira LM, da Silva Coutinho GC, Dutra BG, Martins RV, Reis F, Paiva WS, de RLO A. Esthetics outcomes in patients submitted to pterional craniotomy and its variants: a scoping review. Surg Neurol Int. 2021;12:461. https://doi.org/10.25259/SNI_485_2021 ; PMID: 34621576; PMCID: PMC8492413.
doi: 10.25259/SNI_485_2021 pubmed: 34621576 pmcid: 8492413
van Lindert E, Perneczky A, Fries G, Pierangeli E. The supraorbital keyhole approach to supratentorial aneurysms: concept and technique. Surg Neurol. 1998;49(5):481–9. https://doi.org/10.1016/s0090-3019(96)00539-3 ; discussion 489–90. PMID: 9586924.
doi: 10.1016/s0090-3019(96)00539-3 pubmed: 9586924
Rychen J, Croci D, Roethlisberger M, Nossek E, Potts M, Radovanovic I, Riina H, Mariani L, Guzman R, Zumofen DW. Minimally invasive alternative approaches to Pterional craniotomy: a systematic review of the literature. World Neurosurg. 2018;113:163–79. https://doi.org/10.1016/j.wneu.2018.02.016 ; Epub 2018 Feb 13. PMID: 29452317.
doi: 10.1016/j.wneu.2018.02.016 pubmed: 29452317
Schwartz MS, Anderson GJ, Horgan MA, Kellogg JX, McMenomey SO, Delashaw JB Jr. Quantification of increased exposure resulting from orbital rim and orbitozygomatic osteotomy via the frontotemporal transsylvian approach. J Neurosurg. 1999;91(6):1020–6. https://doi.org/10.3171/jns.1999.91.6.1020 ; PMID: 10584849.
doi: 10.3171/jns.1999.91.6.1020 pubmed: 10584849
Gonzalez LF, Crawford NR, Horgan MA, Deshmukh P, Zabramski JM, Spetzler RF. Working area and angle of attack in three cranial base approaches: pterional, orbitozygomatic, and maxillary extension of the orbitozygomatic approach. Neurosurgery. 2002;50(3):550–5; discussion 555–7. PMID: 11841723.
pubmed: 11841723
Menovsky T, Grotenhuis JA, de Vries J, Bartels RH. Endoscope-assisted supraorbital craniotomy for lesions of the interpeduncular fossa. Neurosurgery. 1999;44(1):106–10. https://doi.org/10.1097/00006123-199901000-00062 ; discussion 110–2. PMID: 9894970.
doi: 10.1097/00006123-199901000-00062 pubmed: 9894970

Auteurs

Stefano Signoretti (S)

Division of Neurosurgery, Department of Emergency and Urgency, S. Eugenio/CTO Hospital, A.S.L. Roma2, Rome, Italy. stefano.signoretti@aslroma2.it.

Lorenzo Pescatori (L)

Division of Neurosurgery, Department of Emergency and Urgency, S. Eugenio/CTO Hospital, A.S.L. Roma2, Rome, Italy.

Barbara Nardacci (B)

Division of Neurosurgery, Department of Emergency and Urgency, S. Eugenio/CTO Hospital, A.S.L. Roma2, Rome, Italy.

Alberto Delitala (A)

Division of Neurosurgery, San Carlo di Nancy Hospital, Rome, Italy.

Alois Zauner (A)

Department of Neurosurgery, Stroke and Neurovascular Center of Central California, Santa Barbara, CA, USA.

Massimiliano Visocchi (M)

Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.

Classifications MeSH