The modified lateral supraorbital approach

Br J Neurosurg. 2018 Aug;32(4):418-423. doi: 10.1080/02688697.2017.1409877. Epub 2017 Dec 6.

Abstract

Purpose: Lateral supraorbital approach is a simpler and quicker method than pterional approach. It provides a more anterior projection when compared to the pterional approach. There are some minor differences of the modified lateral supraorbital approach when compared to lateral supraorbital approach. It is directed more subfrontally and anterior than the pterional and lateral supraorbital approach.

Material and methods: We used modified lateral supraorbital approach in 100 cases between 2012 and 2015 in Medical Park İzmir Hospital/Turkey. The assessed data were as follows: age, gender, Glasgow coma scale at admission, the localization of pathology, the condition of surgical obliteration for aneurysm, excision grade for meningioma, length of stay in the hospital and Glasgow outcoma scale at discharge.

Results: Of all patients, 58 (58%) were men and 42 (42%) were women. Our cases were anterior communicating artery aneurysms (41 cases), tuberculum sella and medial sphenoid wing meningiomas (22 cases), middle cerebral artery aneurysms (15 cases), olfactory groove meningiomas (15 cases), anterior choroidal artery aneurysms (4 cases) and posterior communicating artery aneurysms (3 cases). 4 patients died and the mortality rate of the study cohort was 4%.

Conclusions: The MLSA is faster, simpler and less invasive than the PA and LSA.

Keywords: Modified lateral supraorbital approach; pterional approach; sphenofrontal craniotomy; supraorbital approach.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anterior Cerebral Artery / surgery
  • Cerebral Infarction / surgery
  • Cranial Fossa, Posterior / surgery
  • Craniotomy
  • Female
  • Glasgow Coma Scale
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / mortality
  • Intracranial Aneurysm / surgery*
  • Length of Stay
  • Male
  • Meningioma / diagnostic imaging
  • Meningioma / mortality
  • Meningioma / surgery*
  • Middle Aged
  • Neurosurgical Procedures / methods*
  • Neurosurgical Procedures / mortality
  • Sella Turcica / diagnostic imaging
  • Sella Turcica / surgery*
  • Young Adult