Evaluation of Supraorbital Keyhole approach versus Pterional approach in surgical treatment of Anterior and Middle cranial fossae tumors; A Comparative study

Document Type : Original Articles

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Department of Neurosurgery, Faculty of Medicine, Helwan University, Egypt.

Abstract

Background: Multiple approaches are existing for management of anterior and middle cranial fossae lesions such as frontal, frontotemporal, pterional, orbitozygomatic, and supraorbital approaches. The current study was conducted at Helwan University Hospitals and Nasser Institute Hospital aiming to compare between the classic pterional approach and supraorbital eye brow approaches in the surgical treatment of such lesions.
Patients and methods: A total of 40 cases were included, and they were divided into two groups; the pterional group included 21 cases, while the supraorbital one included 19 cases. The collected data included; preoperative data (age, gender, ASA status, tumour size, and extension), operative data (operative time, operative complications, and blood loss), and post-operative data (hospital stay, pathology, complications, cosmoses, and mortality).
Results: The two approaches did not express significant differences regarding all of the preoperative variables. However, operative time and blood loss were significantly increased in the pterional approach. Gross total resection was achieved in 85.71 and 84.21% of cases in the pterional and suprafrontal approaches respectively. The incidence of brain edema, CSF leakage, and surgical site infection did not significantly differ between the two approaches. However, the supraorbital group was significantly associated with increased eye brow edema, increased supraorbital sensational loss, as well as more cosmetic satisfaction.
Conclusion: Supraorbital eye brow approach has approved itself to be efficacious and safe in dealing with anterior and middle cranial fossae lesions.

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