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ArticleAdvances and technical standards in neurosurgery2023

The Supraorbital Eyebrow Approach in Pediatric Neurosurgery: Perspectives and Challenges of Frontal Keyhole Surgery.

Aminaa Sanchin, Eckart Bertelmann, Pablo Hernáiz Driever, Anna Tietze, Ulrich-Wilhelm Thomale

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Article in Advances and technical standards in neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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3 · Its place in the literature

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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Aminaa SanchinDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Eckart BertelmannDepartment of Ophthalmology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Pablo Hernáiz DrieverDepartment of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Anna TietzeInstitute of Neuroradiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Ulrich-Wilhelm ThomalePediatric Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany. ulrich-wilhelm.thomale@charite.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectSupraorbital craniotomy via an eyebrow incision provides minimally invasive cosmetically favorable access to both orbital and intracranial pathologies. We describe the indication, surgical technique, and clinical course using this surgical approach in a cohort of patients from a single pediatric neurosurgery unit.

methodsIn a retrospective analysis, we identified all surgical cases between January 2013 and April 2022 who underwent the supraorbital craniotomy via an eyebrow incision. Craniotomy was performed using piezosurgery ultrasonic bone incision. An interdisciplinary team of an orbital surgeon and a neurosurgeon performed the orbital surgeries. Clinical and surgical characteristics, perioperative data, possible complications, or redo surgeries as well as ophthalmologic status were assessed.

resultsClinical data of 37 interventions (cases) in 30 patients (age: 8 ± 6.5 years) were analyzed. The supraorbital craniotomy established access to the cranial, lateral, and central portions of the orbit (n = 11) and ipsilateral fronto-medial portions of the skull base (n = 26). Thirty cases suffered from tumor disease with heterogeneous histopathologic diagnoses, and in 13 cases, adjuvant therapy was required. The mean duration of surgery was 163 ± 95 min, and the mean time of hospital stay was 6.0 ± 2.8 days. In two cases (5.4%), the following complications were observed. One infection treated by puncture and antibiotics and one revision surgery was necessary due to loosening of osteosynthesis material. Postoperative visual function was stable compared to preoperative status after all interventions. After a mean follow-up time of 26 ± 25.9 months for oncologic cases the long term outcome was complete remission in 13, stable disease in 14, progressive disease in 1 and death in 2 patients.

conclusionThe supraorbital eyebrow approach is feasible and safe in pediatric neurosurgical cases as a minimally invasive and cosmetic favorable technique and should be considered for intraorbital as well as ipsilateral intracranial lesions adjacent to the skull base. Interdisciplinary cooperation enables a broader spectrum of surgical options in orbital and complex, fronto-basal, skull base pathologies.

Indexed as

CraniotomyEyebrowsNeurosurgical ProceduresOrbitAdolescentChildChild, PreschoolFemaleHumansInfantMaleMinimally Invasive Surgical ProceduresRetrospective StudiesTreatment OutcomeEyebrow approachMinimally invasiveSupraorbital craniotomy

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.