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KMID : 0942820080070020127
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Journal of Korean Brain Tumor Society
2008 Volume.7 No. 2 p.127 ~ p.132
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Supraorbital Approach Through Eyebrow Incision for Treating Tumors in the Anterior Cranial Fossa and Parasellar Region
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Baik Byung-Suck
Jo Kwang-Wook
Kim Young-Woo
Kim Sang-Don
Park Ik-Seong
Baik Min-Woo
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Abstract
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Objective: Keyhole surgery through supraorbital route with eyebrow incision is minimal invasive technique for anterior cranial fossa pathology. Traditional method need to remove supraorbital rim, result in postoperative ecchymosis around eye. The authors performed surgery without removal of supraorbital rim and want to introduce the surgical technique and results.
Methods:Among the patients who were found to have the tumor in the anterior cranial fossa and parasellar area, 9 patients were operated by supraorbital approach. There are 2 tuberculum sellar meningiomas, 3 anterior skull base meningiomas,1 parasellar cavernous hemangioma, 1 Rathke’s cleft cyst, 1 metastatic tumor and 1 optic glioma. Skin incision was made along lateral two third of eyebrow. Small size craniotomy was made just upper part of supraorbital rim. The opening size was 1.5×2.5 cm. Next technique is almost same with traditional supraorbral approach. The surgical results were studied retrospectively.
Results: Largest tumor was 4×5×5 cm in size. Gross total removal was possible in all the patients. There was no surgical mortality and imaging study showed no surgical complication without one case. One patient suffered from hypothalamic dysfunction and sustained moderately disabled state for 6 months but the others showed excellent outcome(modified Rankin Score 0 to 1). The average postoperative hospital day was 9.6 days except 1 patient. All patients were satisfied with cosmetic results. Short Form-36? health survey showed excellent self estimation after surgery.
Conclusion: Minimal invasive approach through eyebrow incision can achieve same results like conventional craniotomy in selected case. Supraorbital rim removal is not an obligation during this procedure.
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KEYWORD
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Supraorbital approach, Anterior fossa, Parasellar region, Minimal invasive tumor surgery
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