A Simplified Skull Base Approaches for Anterior Circulation Aneurysms: Superolateral Orbital Craniotomy and Orbital Roof Craniotomy viaan Eyebrow Incision

ABSTRACT

OBJECTIVE: Previous standard surgical approaches for aneurysms of anterior circulation are concerned with possible injury to the normal brain by cerebral retraction. Simplified skull base approaches have been introduced to fulfill the ideal goals of skull base surgery, brain protection and technical minimalism. Superolateral orbital craniotomy and orbital roof craniotomy via eyebrow incision offered sufficient working space for aneurysmal neck clipping of anterior circulaton and have advantages of minimal brain retraction and rapid recovery. METHODS: The concept and technique of the superolateral orbital craniotomy and orbital roof craniotomy are presented in detail. We conducted a retrospective study in which we evaluated the technical aspect of the superolateral orbital craniotomy and orbital roof craniotomy considering the indications, limitations, and complications of these approaches. RESULTS: The superolateral orbital craniotomy and orbital roof craniotomy provide an ample space to access the neurovascular structure of the anterior skull base without using brain retractors, enable rapid anatomical reconstruction for closure and acceptable cosmetic results. CONCLUSION: The superolateral orbital craniotomy and orbital roof craniotomy via eyebrow incision offer better surgical possibilities and approach related morbidity than conventional approaches in the treatment of anterior circulation aneurysms.