title: Surgical technique of the supraorbital key-hole craniotomy.
abstract: BACKGROUND
  The enormous development of microsurgical techniques and instrumentation together with preoperative planning using the excellent preoperative diagnostic facilities available, enables neurosurgeons to treat more complicated diseases through smaller and more specific approaches.
  
  
  METHODS
  The technical details of the supraorbital key-hole craniotomy are described in this article as it has been evolving in our experience for more than 10 years. After an eyebrow skin incision with careful soft tissue dissection and single frontobasal burr-hole trephination, a supraorbital craniotomy is carried out with a diameter of about 1.5 x 2.5 cm. As a real frontolateral approach, the supraorbital craniotomy avoids removal of the orbital rim, the lesser sphenoid wing or the zygomatic arch.
  
  
  CONCLUSIONS
  The supraorbital craniotomy allows wide intracranial exposure of the deep-seated supra- and parasellar region, according to the concept of key-hole approaches. The limited craniotomy requires minimal brain retraction thus significantly decreasing approach-related morbidity. In addition, the short skin incision within the eyebrow, the careful soft tissue dissection, and the single burr hole trephination result in a pleasing cosmetic outcome.
authors.affiliation: Department of Neurosurgery, Johannes-Gutenberg University Mainz, Langenbeckstrasse 1, D-55131 Mainz, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Reisch
authors.forename: Axel
authors.initials: A
authors.lastname: Perneczky
authors.forename: Ronald
authors.initials: R
authors.lastname: Filippi
mesh_terms: D001927:Brain Diseases / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods*; D009915:Orbit / Q000601:surgery*