title: Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas.
abstract: The improvement of surgical techniques as well as the introduction of new surgical instruments promoted the use of keyhole craniotomies in neurosurgery. We evaluated the technical aspects of the supra-orbital keyhole approach considering the indications, limitations, and complications of this approach to treat anterior cranial fossa and parasellar meningiomas. Twenty-four patients (21 females; mean age, 53 + or - 8.6 years) operated on between 2002 and 2006 through a supra-orbital eyebrow approach were studied. Maximal tumor diameter ranged from 1.6 to 6 cm. Gross total resection was done in 20 (83.3%). All tumors were histologically benign. Two patients (8%) experienced CSF rinorhea and another two patients suffered transitory diabetes insipidus (8%). One patient experienced transitory hemiparesis. There was one case of meningitis and one mortality. Follow-up ranged between 6 to 66 months (mean 31.5 + or - 20.1 months), with no recurrence. The supra-orbital keyhole craniotomy is a useful minimally invasive approach to treat selected anterior fossa and parasellar meningiomas.
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil. mapnpaiva@ig.com.br
authors.forename: Manoel Antonio de
authors.initials: MA
authors.lastname: Paiva-Neto
authors.forename: Oswaldo Inácio de
authors.initials: OI
authors.lastname: Tella
mesh_terms: D000328:Adult; D000368:Aged; D035262:Cranial Fossa, Anterior; D003399:Craniotomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D012658:Sella Turcica; D016896:Treatment Outcome