Abordaje tipo keyhole transciliar supraorbitario. Criterio de seleccion de pacientes / Transciliar supraorbitary keyhole approach. Case selection guidelines

ABSTRACT

Objective: to describe our initial experience with the supraorbital transciliar keyhole approach with emphasis on patients selection criteria. Methods: between july 2003 to june 2004, 7 patients were operated through this approach. Diagnosis included 1 pituitary macroadenoma, 1 craniopharyngioma, 1 clinoidal meningioma, 1 olfactory tract meningioma, 2 ApCom aneurysms and 1 carotid-ophthalmic aneurysm. In all patients the surgical techniqued was similar. Results: many factors demonstrate the advantage of this technique minimal brain exposure, and cerebral retraction, shortened surgical time and early hospital discharge. There were no approach-related complications. All the lesions were of less than 35mm of diameter and under the medial third of the third ventricle. Conclusion: the supraorbital transciliar keyhole approach, endoscope assisted, is a safe way to reach sellar and parasellar lesions when the lesion is of less than 30mm, without extension to posterior fossa