Supraorbital Keyhole Approach: Opening of the Frontal Sinus and Cerebrospinal Fluid Rhinorrhea
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Mehrotra, Anant
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Sanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, IndiaSanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, India
Mehrotra, Anant
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Das, Kuntal Kanti
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机构:Sanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, India
Das, Kuntal Kanti
Rangari, Kamlesh
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机构:Sanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, India
Rangari, Kamlesh
Kanjilal, Soumen
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机构:Sanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, India
Kanjilal, Soumen
Tataskar, Pooja
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机构:Sanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, India
Tataskar, Pooja
Verma, Pawan Kumar
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机构:Sanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, India
Verma, Pawan Kumar
Bhaisora, Kamlesh S.
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Bhaisora, Kamlesh S.
Jaiswal, Awadhesh
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机构:Sanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, India
Jaiswal, Awadhesh
Kumar, Raj
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机构:Sanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, India
Kumar, Raj
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[1] Sanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, India
Introduction: The supraorbital keyhole approach (SOKHA) has been a less invasive alternative for anterior and middle skull base lesions. We aimed to review our data and understand the advantages and limitations of the approach. Methods: We analyzed our data and reviewed 89 consecutive cases who underwent the SOKHA. We included the clinico-radiological parameters, pathology, use of endoscope, complications, etc. for analysis. Results: A total of 47 patients were of aneurysm with a total of 48 aneurysms (39 were ruptured and 9 were unruptured) and Acomm artery aneurysm was the most common site. Meningiomas were the second most common pathology encountered (n = 29). Tuberculum sella meningioma being the most common type of meningiomas operated through this approach. Gross total resection was done in all except two cases in which a small part of the tumor was left behind as the tumor was adhered to blood vessels. Among the remaining cases, craniopharyngiomas (n = 7), optic pathway gliomas (n = 2), hypothalamic hamartomas (n = 2), dermoid (n = 1), and arteriovenous malformation (n = 1) were the other pathologies operated upon. Eight patients had opening of the frontal sinus. Four patients had wound bulge and one patient had cerebrospinal fluid (CSF) rhinorrhea. All these cases were managed conservatively. Conclusion: SOKHA is an excellent approach for anterior cranial fossa lesions especially with properly chosen cases. Incidence of CSF leak in our study is 1.1% and majority can be managed by placement of lumbar drain. Intraoperative obliteration of the frontal sinus can reduce the risk of postoperative CSF leak. A large frontal sinus needs not be a contraindication for SOKHA.
机构:
Sun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R China
Yang, Qintai
Li, Peng
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Sun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R China
Li, Peng
Huang, Jiancong
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Sun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R China
Huang, Jiancong
Wang, Weihao
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Sun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R China
Wang, Weihao
Bian, Shanyan
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Sun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R China
Bian, Shanyan
Huang, Xuekun
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Sun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R China
Huang, Xuekun
Liu, Xian
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Sun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R China
Liu, Xian
Zhang, Gehua
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Sun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 3, Dept Otolaryngol Head & Neck Surg, Guangzhou, Guangdong, Peoples R China
机构:
Hebei Med Univ, Dept Human Anat, Shijiazhuang 050017, Hebei, Peoples R ChinaHebei Med Univ, Dept Human Anat, Shijiazhuang 050017, Hebei, Peoples R China
Yang, Lijun
Wu, Jianliang
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Hebei Med Univ, Hosp 2, Dept Neurosurg, Shijiazhuang 050017, Hebei, Peoples R ChinaHebei Med Univ, Dept Human Anat, Shijiazhuang 050017, Hebei, Peoples R China
Wu, Jianliang
Zhang, Gengshen
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Hebei Med Univ, Hosp 2, Dept Neurosurg, Shijiazhuang 050017, Hebei, Peoples R ChinaHebei Med Univ, Dept Human Anat, Shijiazhuang 050017, Hebei, Peoples R China
Zhang, Gengshen
Zhao, Zongmao
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Hebei Med Univ, Hosp 2, Dept Neurosurg, Shijiazhuang 050017, Hebei, Peoples R ChinaHebei Med Univ, Dept Human Anat, Shijiazhuang 050017, Hebei, Peoples R China
Zhao, Zongmao
Fan, Zhenzeng
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Hebei Med Univ, Hosp 2, Dept Neurosurg, Shijiazhuang 050017, Hebei, Peoples R ChinaHebei Med Univ, Dept Human Anat, Shijiazhuang 050017, Hebei, Peoples R China
Fan, Zhenzeng
Wang, Baozhi
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Hebei Med Univ, Dept Human Anat, Shijiazhuang 050017, Hebei, Peoples R ChinaHebei Med Univ, Dept Human Anat, Shijiazhuang 050017, Hebei, Peoples R China
机构:
China Med Univ, Affiliated Hosp 1, Dept Neurosurg, Shenyang 110001, Liaoning, Peoples R ChinaChina Med Univ, Affiliated Hosp 1, Dept Neurosurg, Shenyang 110001, Liaoning, Peoples R China
Cui Jing-yu
Wu An-hua
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China Med Univ, Affiliated Hosp 1, Dept Neurosurg, Shenyang 110001, Liaoning, Peoples R ChinaChina Med Univ, Affiliated Hosp 1, Dept Neurosurg, Shenyang 110001, Liaoning, Peoples R China
Wu An-hua
Zhang Shi-gang
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China Med Univ, Affiliated Hosp 1, Dept Neurosurg, Shenyang 110001, Liaoning, Peoples R ChinaChina Med Univ, Affiliated Hosp 1, Dept Neurosurg, Shenyang 110001, Liaoning, Peoples R China
Zhang Shi-gang
Qin Xiao-fei
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China Med Univ, Affiliated Hosp 1, Dept Neurosurg, Shenyang 110001, Liaoning, Peoples R ChinaChina Med Univ, Affiliated Hosp 1, Dept Neurosurg, Shenyang 110001, Liaoning, Peoples R China
Qin Xiao-fei
Wang Yun-jie
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China Med Univ, Affiliated Hosp 1, Dept Neurosurg, Shenyang 110001, Liaoning, Peoples R ChinaChina Med Univ, Affiliated Hosp 1, Dept Neurosurg, Shenyang 110001, Liaoning, Peoples R China
机构:
Department of Neurosurgery First Affiliated Hospital of China Medical UniversityDepartment of Neurosurgery First Affiliated Hospital of China Medical University
崔景余
吴安华
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Department of Neurosurgery First Affiliated Hospital of China Medical UniversityDepartment of Neurosurgery First Affiliated Hospital of China Medical University
吴安华
张世刚
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Department of Neurosurgery First Affiliated Hospital of China Medical UniversityDepartment of Neurosurgery First Affiliated Hospital of China Medical University
张世刚
秦晓飞
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机构:
Department of Neurosurgery First Affiliated Hospital of China Medical UniversityDepartment of Neurosurgery First Affiliated Hospital of China Medical University
秦晓飞
王运杰
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机构:
Department of Neurosurgery First Affiliated Hospital of China Medical UniversityDepartment of Neurosurgery First Affiliated Hospital of China Medical University