How I do it: The expanded trans/supraorbital approach for large space-occupying lesions of the anterior fossa

Background The supraorbital rim often interferes with the required upward movement of the instruments for resection of large frontal-lobe tumours through a classic supraorbital craniotomy. Here, we present the expanded trans/supraorbital approach to overcome these limitations. Methods After an eyebr...

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Bibliographic Details
Published in:Acta neurochirurgica 2017-05, Vol.159 (5), p.881-887
Main Authors: Hickmann, Anne-Katrin, Gaida, Britta-Jacqueline, Reisch, Robert
Format: Article
Language:English
Subjects:
Cranial Fossa, Anterior - pathology
Cranial Fossa, Anterior - surgery
Craniotomy - adverse effects
Craniotomy - methods
Eyebrows
How I Do it - Neurosurgical Techniques
Humans
Interventional Radiology
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Orbit - surgery
Postoperative Complications - prevention & control
Surgical Flaps - surgery
Surgical Instruments
Surgical Orthopedics
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Summary:Background The supraorbital rim often interferes with the required upward movement of the instruments for resection of large frontal-lobe tumours through a classic supraorbital craniotomy. Here, we present the expanded trans/supraorbital approach to overcome these limitations. Methods After an eyebrow skin incision, a one-piece bone flap was created incorporating the orbital rim and roof. Basal extension of the craniotomy allowed for a better intracranial visualisation with improved manoeuvrability and angulation of the instruments without using brain retraction. Conclusions This approach poses a feasible alternative to large frontal craniotomies for frontal-lobe tumours, for which a regular supraorbital craniotomy is insufficient.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-017-3082-7