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Minim Invasive Neurosurg 2010; 53(1): 1-8
DOI: 10.1055/s-0030-1247504
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

The Supraorbital Craniotomy for Access to the Skull Base and Intraaxial Lesions: A Technique in Evolution

S. M. Raza1 , T. Garzon-Muvdi1 , K. Boaehene2 , A. Olivi1 , G. Gallia1 , M. Lim1 , P. Subramanian3 , A. Quinones-Hinojosa1
  • 1The Johns Hopkins Neuro-Oncology Surgical Outcomes Research Laboratory and Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  • 2The Johns Hopkins Neuro-Oncology Surgical Outcomes Research Laboratory and Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  • 3The Johns Hopkins Neuro-Oncology Surgical Outcomes Research Laboratory and Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Publication History

Publication Date:
07 April 2010 (online)

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Abstract

Introduction: The supraorbital craniotomy was initially described as a minimally invasive means to target extra-axial lesions in the anterior cranial fossa and sellar/parasellar region. Since its initial description, various modifications have been described. We report our recent experience with this approach (and its modifications) for not only extra-axial but also intra-axial neoplastic pathology.

Methods: Based on patient pathology and anatomic considerations, one of two approaches was performed: supraorbital craniotomy through an eyebrow incision or a combined orbital osteotomy and supraorbital craniotomy through an eyelid incision.

Results: This technique was performed on twenty-eight consecutive patients. Intra-axial pathology ranged from anaplastic astrocytoma to metastasis while extra-axial lesions included meningiomas and skull-based metastases. Excellent lesion resection was achieved in the majority of patients. Complications were infection (2 patients) and CSF leak.

Discussion: The supraorbital craniotomy and its modifications provide an ideal anterior subfrontal approach through which a wide variety of pathology can be approached. This technique has particular considerations in comparison to traditional cranial base approaches that must be taken into account before it is utilized.

Key words

supraorbital approach - orbital ridge osteotomy - skull base

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Correspondence

A. Quinones-HinojosaMD 

MD 21231 Baltimore

USA

Phone: +1/410/502 2906

Fax: +1/410/502 5559

Email: aquinon2@jhmi.edu