Endoscope-assisted supraorbital keyhole approach in early microsurgical clipping of anterior communicating artery aneurysm / 中华神经医学杂志

Objective To evaluate the effectiveness of the endoscope-assisted supraorbital keyhole approach in the early surgical treatment of patients with ruptured anterior communicating artery aneurysms (AcoA). Methods Thirty-five patients with ruptured AcoA, admitted to our hospital from January 2002 to January 2010, adopted clipping via endoscope-assisted supraorbital keyhole approach within 72 h of onset. The neurostatus of these patients were ranged from grade 1 to 3 (Hunt-Hiss Scale scores). The surgical details were described, and the clinical results were assessed according to the scores of Glasgow Outcome Scale.Results Operations were successfully finished in all patients; the endoscope-assisted supraorbital keyhole approach offered sufficient exposure of neurovascular structures for clipping AcoA. Intraoperative accidental aneurysm rupture occurred in 2 patients, but these events were managed successfully by blocking-up the parent artery and performing quick aneurysm neck dissection; no serious complications caused by the surgical approach occurred; postoperative DSA or CTA indicated that the aneurysm was totally clipped and the parent artery appeared no stenosis, and distal artery was unobstructed. Three months after the operation, 30 patients (85.7%) achieved very good outcomes (GOS:4-5 scores). All the patients achieved good cosmetic results. Conclusion In selected AcoA patients with grade 1-3, the endoscope-assisted supraorbital keyhole approach is safe and effective for gaining access to and treating the aneurysms on early hemorrhage stage.

Supraorbital keyhole approach for microsurgical treatment of aneurysms in the anterior circulation / 中华外科杂志

<p><b>OBJECTIVE</b>To study the method with endoscope-assisted microsurgical technique through the supraorbital keyhole approach to treat aneurysms in the anterior circulation.</p><p><b>METHODS</b>According to preoperative diagnostic imagings, to work out of the individual operation planning. Skin incision was made in the eyebrow, and the diameter of supraorbital craniotomy was about 2 cm, endoscope-assisted microsurgical technique was used to clip aneurysm. The technique was used in the most recent 12 consecutive patients.</p><p><b>RESULTS</b>Five different kinds of aneurysms in the anterior circulation were clipped through this method and 12 patients were cured. One patient, intraoperative accidental aneurysm rupture occurred. There were no approach-related complications.</p><p><b>CONCLUSIONS</b>This endoscope-assisted microsurgical technique via supraorbital keyhole approach is a safe, minimal invasive and effective way for the treatment of aneurysms in the anterior circulation, and there is more sufficient operating space.</p>

Endoscope-assisted supraorbital keyhole approach for excision of suprasellar region tumor / 中华外科杂志

<p><b>OBJECTIVE</b>To study endoscope-assisted microsurgical technique with supraorbital keyhole approach for the treatment of suprasellar region tumor so as to maximize tumor removal and minimize operative-trauma.</p><p><b>METHODS</b>According to high resolution CT and MR images before operation, individual operation schemes were worked out. Skin incision was made in the eyebrow, and the diameter of supraorbital craniotomy was approximately 2 cm. Endoscope-assisted microsurgical technique was used to resect lesions in 16 consecutive patients.</p><p><b>RESULTS</b>Total Tumors were removed in all of the 16 patients via the supraorbital keyhole approach. No postoperative complications occurred.</p><p><b>CONCLUSIONS</b>Supraorbital keyhole approach may diminish tissue injury considerably and has proven to provide sufficient operating space in the suprasellar region for tumor removal.</p>