Supraorbital keyhole approach for suprasellar arachnoid cyst: how I do it
Keyhole approaches have lately sparked strong interest because these approaches address skull base pathologies as reported by Eroglu et al. (World Neurosurg, 2019); Hickmann, Gaida, and Reisch (Acta Neurochir (Wien) 159:881–887, 2017); Jallo and Bognar (Neurosurgery, 2006); and Poblete et al. (J Neurosurg 122:1274–1282, 2015), minimizing brain retraction and improving cosmetic results. We describe the step-by-step surgical technique to drain a suprasellar arachnoid cyst by a supraorbital approach.
The eyebrow incision is a direct route to expose the supraorbital corridor and even if it is smaller than a pterional approach, it permits to open the cisterns and to visualize neurovascular structures. The arachnoid cyst could be safely drained and a T-tube is placed.
This technique represents a suitable option for suprasellar arachnoid cyst, avoiding more extended and invasive approaches.
KeywordsSupraorbital approach Eyebrow incision Minimally invasive technique Suprasellar cyst
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Informed consent was obtained from the individual participant included in the study.
Suprasellar arachnoid cyst opening by supraorbital keyhole approach through eyebrow skin incision. (MP4 252139 kb)
- 1.Eroglu U, Shah K, Bozkurt M, Kahilogullari G, Yakar F, Dogan I, Ozgural O, Attar A, Unlu A, Caglar S, Cohen Gadol AA, Ugur HC (2019) Supraorbital keyhole approach: lessons learned from 106 operative cases. World Neurosurg doi: https://doi.org/10.1016/j.wneu.2018.12.188
- 3.Jallo GI, Bognar L (2006) Eyebrow surgery: the supraciliary craniotomy: technical note. Neurosurgery 59:ONSE157–ONSE158; discussion ONSE157-158. https://doi.org/10.1227/01.NEU.0000220045.23743.80 CrossRefPubMedGoogle Scholar
- 8.Tubbs RS, Loukas M, Shoja MM, Cohen-Gadol AA (2010) Refined and simplified surgical landmarks for the MacCarty keyhole and orbitozygomatic craniotomy. Neurosurgery 66:230–233. https://doi.org/10.1227/01.NEU.0000369650.69583.9C CrossRefPubMedGoogle Scholar