The fully endoscopic supraorbital trans-eyebrow keyhole approach to the anterior and middle skull base

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The purely endoscopic eyebrow supraorbital approach is an alternative to both the endoscopic endonasal and eyebrow microsurgical routes to the anterior and middle cranial base. It combines an enhanced visualization provided by the endoscope and the absence of cerebrospinal fluid (CSF) leaks and nasal complications.


A trans-eyebrow 2-cm craniotomy is designed to allow the placement of a straight endoscope and visualize the skull base from the cribriform plate to the mesiotemporal lobe.


Visualization is considerably improved, while the keyhole mini-invasive concept is respected.


The purely endoscopic eyebrow supraorbital keyhole approach is a valuable and alternative minimally invasive route to anterior and middle skull base lesions.

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  1. 1.

    Czirják S, Szeifert GT (2001) Surgical experience with frontolateral keyhole craniotomy through a superciliary skin incision. Neurosurgery 48:145–149

  2. 2.

    Fries G, Reisch R (1996) Biportal neuroendoscopic microsurgical approaches to the subarachnoid cisterns. A cadaver study. Minim Invasive Neurosurg 39:99–104

  3. 3.

    Jane JA, Park TS, Pobereskin LH, Winn HR, Butler AB (1982) The supraorbital approach: technical note. Neurosurgery 11:537–542

  4. 4.

    Kabil MS, Shahinian HK (2005) Application of the supraorbital endoscopic approach to tumors of the anterior cranial base. J Craniofac Surg 16:1070–1074

  5. 5.

    Kabil MS, Shahinian HK (2006) The endoscopic supraorbital approach to tumors of the middle cranial base. Surg Neurol 66:396–401

  6. 6.

    Kabil MS, Shahinian HK (2007) Fully endoscopic supraorbital resection of congenital middle cranial fossa arachnoid cysts: report of 2 cases. Pediatr Neurosurg 43:316–322

  7. 7.

    Menovsky T, Grotenhuis JA, de Vries J, Bartels RH (1999) Endoscope-assisted supraorbital craniotomy for lesions of the interpeduncular fossa. Neurosurgery 44:106–110

  8. 8.

    Perneczky A, Fries G (1998) Endoscope-assisted brain surgery: part 1–evolution, basic concept, and current technique. Neurosurgery 42:219–224

  9. 9.

    Reisch R, Perneczky A (2005) Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision. Neurosurgery 57:242–255

  10. 10.

    van Lindert E, Perneczky A, Fries G, Pierangeli E (1998) The supraorbital keyhole approach to supratentorial aneurysms: concept and technique. Surg Neurol 49:481–489

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Correspondence to Emmanuel Jouanneau.

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Berhouma, M., Jacquesson, T. & Jouanneau, E. The fully endoscopic supraorbital trans-eyebrow keyhole approach to the anterior and middle skull base. Acta Neurochir 153, 1949 (2011) doi:10.1007/s00701-011-1089-z

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  • Skull base surgery
  • Minimally invasive neurosurgery
  • Keyhole surgery
  • Anterior cranial fossa
  • Middle cranial fossa
  • Eyebrow
  • Supraorbital craniotomy
  • Endoscopy
  • Skull base tumors