Endoscopic Assisted Supraorbital Approach for Tumors of Anterior and Middle Skull Base

Abstract

Background Data: The supraorbital eyebrow approach is a minimally invasive keyhole technique that offers wide access to the anterior skull base and parasellar region using the subfrontal corridor, with assistances of neuroendoscopy The approach through the eyebrow permits access to a number of lesions in the subfrontal corridor with minimal brain retraction and a much smaller area of potential injury of main structures. Study Design: This study is a follow up study. Objective: To evaluate the role of supraorbital endoscopic approach for tumors of anterior and middle skull base. Patients and Methods: All the operations were performed at Suez Canal University hospitals, in about 24 months, the first 30 patients having tumors of anterior and middle skull base fulfilling the inclusion criteria were included in this prospective study. Results: Endoscopy can play an important role in improving visualization through the keyhole corridor. With the use of neuroendoscopy, the reach of this approach may be extended even further to include the pituitary fossa, the top third of the clivus, the interpeduncular cistern, the anterior third ventricle, and the medial and anterior temporal lobe and middle fossa.The major advantage of the supraorbital over the endonasal route is a simplified skull base closure and reduced risk of postoperative CSF leak. It is a valuable approach for selected patients. Neuromonitoring may further increase surgical safety. Conclusion: The approach through the eyebrow permits access to a number of lesions in the subfrontal corridor With the use of the assisstence of neuroendoscopy, with minimal brain retraction and a much smaller area of potential injury of anatomical structures.