Background: The eyebrow supraorbital keyhole approach could be considered a modified minimally invasive model for the classic pterional subfrontal approach in which an eyebrow incision and supraorbital mini craniotomy...Background: The eyebrow supraorbital keyhole approach could be considered a modified minimally invasive model for the classic pterional subfrontal approach in which an eyebrow incision and supraorbital mini craniotomy are performed for exposure of the anterior cranial fossa corridor. Methods: This study was retrospectively conducted on twenty four patients, age ranging from 20 to 65 years old, with anterior cranial fossa lesions who were meeting the eligibility criteria for eyebrow craniotomy in the period from August 2019 to January 2023. These patients were operated through eyebrow supraorbital approach in which microscopic endoscopic assisted technique were used. Extent of resection, clinical and cosmetic outcomes and complication incidence were assessed. Results: We included the twenty four patients who met inclusion criteria (17 females and 7 males) their ages ranged from 20 to 65 years. The most common pathology was meningioma in 19 patients. Two patients experienced supraorbital loss of sensation and only one patient experienced palsy of frontalis branch of facial nerve. Frontal sinus was breached in 3 patients with no patient experienced postoperative CSF leak. Total excision was accomplished for 23 patients. Four patients who had preoperative visual compromise, improvement of visual acuity and field defects was observed in 3 patients. No major intraoperative complications occurred. All patients filled cosmetic satisfaction questionnaire during their outpatient visits. For the eyebrow supraorbital approach, no incision related intolerable pain, no craniotomy defects or irregularities, no cosmetic complaints nor limitation of jaw opening were reported, and only minor symptoms in the form of limited eyebrow elevation, swelling and numbness in the forehead. Conclusions: The eyebrow craniotomy could be used safely as a more cosmetic and minimally invasive approach for a variety of anterior cranial fossa lesions. Endoscopic assistance has been found very useful for deeply seated lesions and hidden residuals wi展开更多
This study was designed to compare the approaches and efficacies of two different ways of neurosurgical management for spontaneous putaminal hemorrhage(SPH):computed tomographic-guided aspiration(CTGA)and the key-hole...This study was designed to compare the approaches and efficacies of two different ways of neurosurgical management for spontaneous putaminal hemorrhage(SPH):computed tomographic-guided aspiration(CTGA)and the key-hole approach(KHA).The indications of the two approaches are also explored.From September 2001 to 2003,a total of 1077 cases of SPH distributed in 135 hospitals all over the mainland of China were included for analysis.All cases had three-month follow-up data.The study was designed in a single-blinded manner to compare the efficacies of the different approaches.There were 563 cases in the CTGA group,165 in the KHA group,and 217 cases in the conventional open craniotomy(COC)group.In the CTGA and KHA groups,the mortalities at one month after operation(M1m)were 17.9% and 18.3%,respectively,while the mortalities at three months after operation(M3m)were 19.4% and 19.4%,respectively(P>0.05).The postoperative complications due to CTGA(23.7%)were not significantly different from those due to KHA(25.7%)(P=0.420).The M3m of patients with Glasgow coma scale(GCS)h8 was 3.45 and 4.0 times as much as those with GCS>8,respectively.The M3m of patients with complications was 3.92 times as much as those without complications.The M3m of patients with hemorrhage volume ≥70 mL was 2.67 times as much as those<70 mL.The CTGA is not better than KHA in the treatment of SPH in terms of a more favorable outcome or less mor tality and morbidity,but CTGA could be the first choice for those with bleeding volumes ≤50mL,while KHA is the first choice for those with bleeding volumes>50 mL.展开更多
Background Keyhole surgery has developed since the 1990s as a less invasive therapeutic strategy for intracranial lesions, initially for the treatment of intracranial aneurysms. The purpose of this study was to descri...Background Keyhole surgery has developed since the 1990s as a less invasive therapeutic strategy for intracranial lesions, initially for the treatment of intracranial aneurysms. The purpose of this study was to describe and evaluate the results of surgical treatment of lesions in the anterior fossa and sellar region via a supraorbital keyhole approach using eyebrow incisions. Methods Between April 1994 and July 2003, 54 patients with lesions in the anterior fossa and sellar region were operated on via the supraorbital keyhole approach. The surgical results were studied retrospectively and compared with that of patients with lesions at the same locations but treated via a conventional subfrontal approach.Results No significant difference in curative effect was found between the conventional subfrontal approach and the supraorbital keyhole approach. However, the supraorbital approach required a much smaller skin incision, causing less surgical trauma, while achieving excellent surgical exposure and good recovery. Conclusion The supraorbital keyhole approach using an eyebrow incision is safe, effective, and both suitable and convenient for treating lesions in the anterior fossa and sellar region, with almost no adverse consequences on the facial features of patients.展开更多
目的探讨小骨窗经外侧裂显微手术治疗高血压性基底节区脑出血疗效。方法选择我院2013年12月至2015年2月30例出血量在30~60 m L的基底节区出血患者,对其手术过程及疗效进行回顾,总结小骨窗经外侧裂显微手术的方法及技巧,对比分析了传统...目的探讨小骨窗经外侧裂显微手术治疗高血压性基底节区脑出血疗效。方法选择我院2013年12月至2015年2月30例出血量在30~60 m L的基底节区出血患者,对其手术过程及疗效进行回顾,总结小骨窗经外侧裂显微手术的方法及技巧,对比分析了传统手术优缺点。结果患者术后24 h复查CT颅内血肿清除90%以上,1例出现颞叶脑梗塞,无再次出血及死亡病例。患者术后意识恢复良好,通过早期康复治疗,肢体功能、语言功能均不同程度好转。结论小骨窗经侧裂显微镜下清除基底节区中等量血肿具有创伤小、止血彻底、功能保护好等明显优点,可在神经外科手术中推广应用。展开更多
文摘Background: The eyebrow supraorbital keyhole approach could be considered a modified minimally invasive model for the classic pterional subfrontal approach in which an eyebrow incision and supraorbital mini craniotomy are performed for exposure of the anterior cranial fossa corridor. Methods: This study was retrospectively conducted on twenty four patients, age ranging from 20 to 65 years old, with anterior cranial fossa lesions who were meeting the eligibility criteria for eyebrow craniotomy in the period from August 2019 to January 2023. These patients were operated through eyebrow supraorbital approach in which microscopic endoscopic assisted technique were used. Extent of resection, clinical and cosmetic outcomes and complication incidence were assessed. Results: We included the twenty four patients who met inclusion criteria (17 females and 7 males) their ages ranged from 20 to 65 years. The most common pathology was meningioma in 19 patients. Two patients experienced supraorbital loss of sensation and only one patient experienced palsy of frontalis branch of facial nerve. Frontal sinus was breached in 3 patients with no patient experienced postoperative CSF leak. Total excision was accomplished for 23 patients. Four patients who had preoperative visual compromise, improvement of visual acuity and field defects was observed in 3 patients. No major intraoperative complications occurred. All patients filled cosmetic satisfaction questionnaire during their outpatient visits. For the eyebrow supraorbital approach, no incision related intolerable pain, no craniotomy defects or irregularities, no cosmetic complaints nor limitation of jaw opening were reported, and only minor symptoms in the form of limited eyebrow elevation, swelling and numbness in the forehead. Conclusions: The eyebrow craniotomy could be used safely as a more cosmetic and minimally invasive approach for a variety of anterior cranial fossa lesions. Endoscopic assistance has been found very useful for deeply seated lesions and hidden residuals wi
文摘This study was designed to compare the approaches and efficacies of two different ways of neurosurgical management for spontaneous putaminal hemorrhage(SPH):computed tomographic-guided aspiration(CTGA)and the key-hole approach(KHA).The indications of the two approaches are also explored.From September 2001 to 2003,a total of 1077 cases of SPH distributed in 135 hospitals all over the mainland of China were included for analysis.All cases had three-month follow-up data.The study was designed in a single-blinded manner to compare the efficacies of the different approaches.There were 563 cases in the CTGA group,165 in the KHA group,and 217 cases in the conventional open craniotomy(COC)group.In the CTGA and KHA groups,the mortalities at one month after operation(M1m)were 17.9% and 18.3%,respectively,while the mortalities at three months after operation(M3m)were 19.4% and 19.4%,respectively(P>0.05).The postoperative complications due to CTGA(23.7%)were not significantly different from those due to KHA(25.7%)(P=0.420).The M3m of patients with Glasgow coma scale(GCS)h8 was 3.45 and 4.0 times as much as those with GCS>8,respectively.The M3m of patients with complications was 3.92 times as much as those without complications.The M3m of patients with hemorrhage volume ≥70 mL was 2.67 times as much as those<70 mL.The CTGA is not better than KHA in the treatment of SPH in terms of a more favorable outcome or less mor tality and morbidity,but CTGA could be the first choice for those with bleeding volumes ≤50mL,while KHA is the first choice for those with bleeding volumes>50 mL.
文摘Background Keyhole surgery has developed since the 1990s as a less invasive therapeutic strategy for intracranial lesions, initially for the treatment of intracranial aneurysms. The purpose of this study was to describe and evaluate the results of surgical treatment of lesions in the anterior fossa and sellar region via a supraorbital keyhole approach using eyebrow incisions. Methods Between April 1994 and July 2003, 54 patients with lesions in the anterior fossa and sellar region were operated on via the supraorbital keyhole approach. The surgical results were studied retrospectively and compared with that of patients with lesions at the same locations but treated via a conventional subfrontal approach.Results No significant difference in curative effect was found between the conventional subfrontal approach and the supraorbital keyhole approach. However, the supraorbital approach required a much smaller skin incision, causing less surgical trauma, while achieving excellent surgical exposure and good recovery. Conclusion The supraorbital keyhole approach using an eyebrow incision is safe, effective, and both suitable and convenient for treating lesions in the anterior fossa and sellar region, with almost no adverse consequences on the facial features of patients.
文摘目的探讨小骨窗经外侧裂显微手术治疗高血压性基底节区脑出血疗效。方法选择我院2013年12月至2015年2月30例出血量在30~60 m L的基底节区出血患者,对其手术过程及疗效进行回顾,总结小骨窗经外侧裂显微手术的方法及技巧,对比分析了传统手术优缺点。结果患者术后24 h复查CT颅内血肿清除90%以上,1例出现颞叶脑梗塞,无再次出血及死亡病例。患者术后意识恢复良好,通过早期康复治疗,肢体功能、语言功能均不同程度好转。结论小骨窗经侧裂显微镜下清除基底节区中等量血肿具有创伤小、止血彻底、功能保护好等明显优点,可在神经外科手术中推广应用。
