Summary
Objective. The standard pterional approach has been used to approach aneurysms of the anterior circulation and the basilar tip, suprasellar tumors, cavernous lesions. The senior author (JH) established a lateral supraorbital approach as an alternative to the pterional approach after continuous trial and error. We describe the techniques of this approach based on clinical experiences.
Methods. The lateral supraorbital approach is more subfrontal and anterior than the pterional approach. This approach has been regularly used by the senior author (JH) in the last decade in more than 2000 operations for mostly aneurysms of anterior circulation, but also for tumors of the anterior fossa and parasellar area as well as the sphenoid wing area.
Results. This approach can be used to operate on most cases, in which the classical pterional approach would be used. There are almost no craniotomy-related complications with this approach. This approach is not suitable in certain lesions which need to be exposed from a more temporal perspective.
Conclusion. This approach is simpler, faster, safer and less invasive than the classical pterional approach.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Brock M, Dietz H (1978) The small frontolateral approach for the microsurgical treatment of intracranial aneurysms. Neurochirurgia 21: 185–191
Menovsky T, Grotenhuis A, de Vries J, Bartels RHMA (1999) Endoscope-assisted supraorbital craniotomy for lesions of the interpeduncular fossa. Neurosurgery 44: 106–112
Reisch R, Perneczky A, Filippi R (2003) Surgical technique of the supraorbital key-hole craniotomy. Surg Neurol 59: 223–227
Rinne J, Shen H, Kivisaari R, Hernesniemi JA (2000) Surgical management of aneurysms of the middle cerebral artery. In: Schmidek HH (ed) Operative neurosurgical techniques: indications, methods, and results, 4th edn. WBSaunders Co., Philadelphia, pp 1159–1180
van Lindert E, Perneczky A, Fries G, Pierangeli E (1998) The supraorbital keyhole approach to supratentorial aneurysms: concept and technique. Surg Neurol 49: 481–490
Wilson DH: Limited exposure in cerebral neurosurgery (1971) Technical note. J Neurosurg: 102–106
Yaşargil MG, Fox JL, Ray MW (1975) The operative approach to aneurysms of the anterior communicating artery. Adv Tech Stand Neurosurg 2: 113–170
Yaşargil MG, Antic J, Laciga R, Jain KK, Hodosh RM, Smith RD (1976) Microsurgical pterional approach to aneurysms of the basilar bifurcation. Surg Neurol 6: 83–91
Yaşargil MG (1984) Vertebrobasilar aneurysms. In: Microneurosurgery, vol 2. Georg Thieme Verlag, Stuttgart, pp 232–295
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Springer-Verlag
About this paper
Cite this paper
Hernesniemi, J. et al. (2005). Lateral supraorbital approach as an alternative to the classical pterional approach. In: Yonekawa, Y., Keller, E., Sakurai, Y., Tsukahara, T. (eds) New Trends of Surgery for Stroke and its Perioperative Management. Acta Neurochirurgica Supplements, vol 94. Springer, Vienna. https://doi.org/10.1007/3-211-27911-3_4
Download citation
DOI: https://doi.org/10.1007/3-211-27911-3_4
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-24338-1
Online ISBN: 978-3-211-27911-3
eBook Packages: MedicineMedicine (R0)