Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(03): 767-772
DOI: 10.4103/ajns.AJNS_40_19
Original Article

Supraorbital craniotomy for large anterior skull base meningiomas: A technical note

Kiran Khanapure
1   Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka
,
Krishna Joshi
1   Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka
2   The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
,
Aniruddha Jagannatha
1   Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka
,
Parichay Perikal
1   Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka
,
Syed Quryshi
1   Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka
,
Umesh Srikantha
1   Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka
3   Department of Neurosurgery, Institute of Neurosciences, Aster Hospital, Bengaluru, Karnataka
,
Ravi Verma
1   Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka
3   Department of Neurosurgery, Institute of Neurosciences, Aster Hospital, Bengaluru, Karnataka
,
Alankar Hegde
1   Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Background: Supraorbital craniotomy (SOC) has brought a paradigm shift in approaching anterior skull base lesions. With better understanding of relevant anatomy, the indications are being stretched from highly selected, small-to-moderate-sized tumors to large and complex anterior skull base lesions. Objective: We share our experience and discuss the nuances of surgery for large anterior skull base meningiomas using the SOC. Methods: This is a single institute study using prospectively collected retrospective data from seven cases of large anterior skull base meningiomas (>3 cm) using the SOC. We reviewed the indications, safety, and procedural complications in these cases. Results: Simpson's Grade 2 excision was achieved in all these seven cases, with faster postoperative recovery. Follow-up clinical outcome and cosmesis were satisfactory. Conclusion: SOC is a safe alternative for the standard skull base approaches in treating large anterior skull base meningiomas. The SOC can be effectively used to treat selected large anterior skull base meningiomas.

Key-words:

Brow craniotomy - meningiomas - minimally-invasive - skull base - supraorbital

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Abbassy M, Woodard TD, Sindwani R, Recinos PF. An overview of anterior skull base meningiomas and the endoscopic endonasal approach. Otolaryngol Clin North Am 2016;49:141-52.
  • 2 Raizer J, Sherman Sojka WJ. Meningiomas. In: Packer RJ, Schiff D, editors. Neuro-Oncology. Oxford, UK: Blackwell Publishing Ltd.; 2012. p. 115-24.
  • 3 Perneczky A, Müller-Forell W, Van Lindert E, Fries G. Keyhole Concept in Neurosurgery. Stuttgart, Germany: Thieme Medical Publishers; 1999.
  • 4 Reisch R, Perneczky A. Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision. Neurosurgery 2005;57:242-55.
  • 5 Mahmoud M, Nader R, Al-Mefty O. Optic canal involvement in tuberculum sellae meningiomas: Influence on approach, recurrence, and visual recovery. Neurosurgery 2010;67:ons108-18.
  • 6 da Silva CE, de Freitas PE. Large and giant skull base meningiomas: The role of radical surgical removal. Surg Neurol Int 2015;6:113.
  • 7 Morales-Valero SF, Van Gompel JJ, Loumiotis I, Lanzino G. Craniotomy for anterior cranial fossa meningiomas: Historical overview. Neurosurg Focus 2014;36:E14.
  • 8 van Lindert E, Perneczky A, Fries G, Pierangeli E. The supraorbital keyhole approach to supratentorial aneurysms: Concept and technique. Surg Neurol 1998;49:481-9.
  • 9 Fatemi N, Dusick JR, de Paiva Neto MA, Malkasian D, Kelly DF. Endonasal versus supraorbital keyhole removal of craniopharyngiomas and tuberculum sellae meningiomas. Operative Neurosurg 2009;64:ons269-87.
  • 10 Ormond DR, Hadjipanayis CG. The supraorbital keyhole craniotomy through an eyebrow incision: Its origins and evolution. Minim Invasive Surg 2013;2013:296469.
  • 11 Gazzeri R, Nishiyama Y, Teo C. Endoscopic supraorbital eyebrow approach for the surgical treatment of extraaxialand intraaxial tumors. Neurosurg Focus 2014;37:E20.
  • 12 Iacoangeli M, Nocchi N, Nasi D, DI Rienzo A, Dobran M, Gladi M, et al. Minimally invasive supraorbital key-hole approach for the treatment of anterior cranial fossa meningiomas. Neurol Med Chir (Tokyo) 2016;56:180-5.
  • 13 Zumofen DW, Rychen J, Roethlisberger M, Taub E, Kalbermatten D, Nossek E, et al. A review of the literature on the transciliary supraorbital keyhole approach. World Neurosurg 2017;98:614-24.