Turkish Neurosurgery 2013 , Vol 23 , Num 4
Supraorbital Keyhole Approach for Anterior Circulation Aneurysms
Chao TANG1, Jun SUN2, Hongli XUE3, Yong YU3, Feng XU3
1Huashan Hospital Affiliated to Fudan University, Department of Neurosurgery, Shanghai, China
2Xinhua Hospital of Hubei Province, Department of Neurosurgery, Wuhan Hubei, China
3The General Hospital of Shenyang Military Region, Department of Neurosurgery, Shenyang Liaoning, China
DOI : 10.5137/1019-5149.JTN.6160-12.1 Aim: Supraorbital keyhole approach provides access to the major part of the anterior circulation aneurysms. Herein, our surgical experience of supraorbital keyhole approach and its some modification have been proposed.

Material and Methods: Out of a series of 76 patients harboring 80 aneurysms operated on via a supraorbital keyhole approach with a superciliar or front wrinkle skin incision, there are 70 patients with subarachnoidal bleeding, others are nonruptured aneurysms, Intraoperative rupture occurred in 8 cases, and 4 had multiple aneurysms.

Results: There was a good cosmetic results with less approach-related complications .Of 80 aneurysms, 75 aneurysms were clipped successfully by the supraorbital route. Good Glasgow Outcome Scale scores of 4 or 5 were achieved in 95% of the patients at the time of discharge. 2 patients of Grade IV died in the postoperative period due vasospasm.

Conclusion: The supraorbital route is recommended for selected anterior circulation aneurysms based on the improved surgical instruments and microsurgical skills. Keywords : Supraorbital craniotomy, Keyhole approach, Anterior cerebral aneurysms

Corresponding author : Chao Tang, tangchao314159@aliyun.com