Supraorbital Keyhole Approach: Opening of the Frontal Sinus and Cerebrospinal Fluid Rhinorrhea

被引:0
|
作者
Mehrotra, Anant [1 ]
Das, Kuntal Kanti
Rangari, Kamlesh
Kanjilal, Soumen
Tataskar, Pooja
Verma, Pawan Kumar
Bhaisora, Kamlesh S.
Jaiswal, Awadhesh
Kumar, Raj
机构
[1] Sanjay Gandhi Post Grad Inst Med Sci, Neurosurg, Lucknow, Uttar Pradesh, India
关键词
SOKHA; CSF leak; frontal sinus; EXPERIENCE;
D O I
10.1055/a-2297-3768
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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.
引用
收藏
页码:160 / 164
页数:5
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