Supraorbital Keyhole approach in anterior circulation intracranial aneurysms surgery

Authors

  • Ángel Jesús Lacerda Gallardo
  • Daiyan Martín Chaviano
  • Yaima Mirabal García
  • Johanna Quintana Záez
  • Norka Tacas Gil

Keywords:

Intracranial aneurysms, Subarachnoid hemorrhage, Supraorbital Keyhole, Neurosurgery

Abstract

OBJECTIVE: To asses surgical results in patients with anterior circulation intracranial aneurysms treated by two different approaches, the supraorbital keyhole and pterional craniotomy.

METHODS: A non–randomized surgical trial was carried out in which the patients was assigned to KHSO group if the approach selected was supraorbital Keyhole or CPT group if the approach was pterional craniotomy.

RESULTS: 125 cases were studied, 77 (61.60 %) in KHSO group and 48 (38.40 %) in CPT group. 153 aneurysmal sacs were treated, 93 in KHSO group and 60 in CPT group, 119 rupture (77.77 %) and 34 without rupture (22.23 %).

CONCLUSIONS: There were no significant differences between the two groups. The supraorbital Keyhole is an alternative option in surgical treatment of anterior circulation intracranial aneurysms.

Downloads

Download data is not yet available.

Author Biography

Ángel Jesús Lacerda Gallardo

Doctor en ciencias médicas, especialista de 2do grado en neurocirug'[ia.Profesor auxiliar.Investigador auxiliar. Diplomado en cuidados intensivos del adulto.

References

1. Brock M, Dietz H. The small frontolateral approach for the microsurgical treatment of intracranial aneurysms. Neurochirurgia (Stuttg). 1978;21:185–91.

2. Perneczky A, Fries G. Endoscope–assisted brain surgery: part 1–evolution, basic concept, and current technique. Neurosurgery. 1998;42:219–25.

3. van Lindert E, Perneczky A, Fries G, Pierangeli E. The supraorbital keyhole approach to supratentorial aneurysms: concept and technique. Surg. Neurol. 1998;49:481–90.

4. Fischer G, Stadie A, Reisch R, Hopf NJ, Fries G, Böcher–Schwarz H et al. The keyhole concept in aneurysm surgery: results of the past 20 years. Neurosurgery. 2011;68 (1)(Suppl Operative):45–51.

5. Carmona Rammsy P. Abordaje minimamente invasivo lateral Key–hole. Experiencia de 64 casos. Rev Chil Neurocirugía. 2011;36:11–9.

6. Park J, Kang D–H, Chun B–Y. Superciliary keyhole surgery for unruptured posterior communicating artery aneurysms with oculomotor nerve palsy: maximizing symptomatic resolution and minimizing surgical invasiveness. JNS. 2011;115 (4):700–6.

7. Cheng C–M, Noguchi A, Dogan A, Anderson GJ, Hsu FPK, McMenomey SO et al. Quantitative verification of the keyhole concept: a comparison of area of exposure in the parasellar region via supraorbital keyhole, frontotemporal pterional, and supraorbital approaches. JNS. 2013;118(2):264–69.

8. Park J, Jung T, Kang D–H, Lee S–H. Preoperative percutaneous mapping of the frontal branch of the facial nerve to assess the risk of frontalis muscle palsy after a supraorbital keyhole approach. JNS. 2013;118 (5):1114–9.

9. Drake CG. Report of world federation of neurosurgical surgeon committee on a universal SAH grading scale. JNS. 1988;68:985–6.

10. Patriota GC, da Silva–Júnior JM, Evangelista Santos Barcellos AC, de Sousa Silva Júnior J B, Oliveira Toledo D P, Campos Gomes Pinto F et al. Determining ICH Score: can we go beyond?. Arq Neuro–Psiquiatr [Internet]. 2009 Sep [citado 2012 June 25]; 67(3a): [aprox. 4p.]. Available from: http://dx.doi.org/10.1590/S0004–282X2009000400006

11. Spagnuolo E, Quintana L. Hemorragia subaracnoidea por aneurisma cerebral roto. Guías de manejo clínico actualizadas 2010. Una propuesta al capítulo vascular de la FLANC. Rev Chil Neurocirugía. 2010;35:72–86.

12. Perneczky A, Reisch R, Kindel S, Tschabitscher M. Keyhole Approaches in Neurosurgery. Concept and surgical technique. Austria: Springer–Verlag wien; 2008.

13. Park J, Woo H, Kang DH, Sung JK, Kim Y. Superciliary keyhole approach for small unruptured aneurysms in anterior cerebral circulation. Neurosurgery. 2011;68:2300–9.

14. Figueiredo E, Deshmukh V, Deshmukh P, Crusius MU, Crawford N, Speztler R, et al. An Anatomical Evaluation of the Mini–Supraorbital Approach and Comparison with Standard Craniotomies. Neurosurgery. 2006;59(Suppl 4):212–20.

15. Butron OM. Abordajes craneanos mínimamente invasivos tipo keyhole para patología neuroquirúrgica. Rev Med Clin Condes. 2008;19(5):590–4.

16. McLaughlin N, Cutler A, Martin NA. Technical nuances of temporal muscle dissection and reconstruction for the pterional keyhole craniotomy. Technical note. JNS. 2013;118(2):309–14.

Published

2014-07-01

How to Cite

1.
Lacerda Gallardo Ángel J, Martín Chaviano D, Mirabal García Y, Quintana Záez J, Tacas Gil N. Supraorbital Keyhole approach in anterior circulation intracranial aneurysms surgery. Rev Cubana Neurol Neurocir [Internet]. 2014 Jul. 1 [cited 2025 Jul. 3];4(2):130-5. Available from: https://revneuro.sld.cu/index.php/neu/article/view/138

Issue

Section

Original research