title: The usefulness of the frontolateral approach as a minimally invasive corridor for clipping of anterior circulation aneurysm.
abstract: OBJECTIVE
  Several studies have reported on the effectiveness of fronto-lateral craniotomy in reducing the operating time and post-operative complications. However, no study has practically evaluated this method from the cosmetic point of view.
  
  
  METHODS
  We designed this study for comparison of the clinical differences and cosmetic outcomes between the frontolateral craniotomy and the conventional pterional craniotomy for clipping of unruptured intracranial aneurysms. We performed a retrospective analysis of the two groups based on their medical records and radiologic findings juxtaposed with their length of hospital stay, intensive care unit day and operation time, and the emergence of postoperative complication, mean size of aneurysm, and temporal depression.
  
  
  RESULTS
  After careful comparison of the thickness of temporalis muscle between the craniotomy side and the contralateral side, the results clearly showed that the conventional pterional craniotomy group was asymmetric by a p value of 0.152 and the frontolateral craniotomy group was symmetric by a p value of 0.002.
  
  
  CONCLUSIONS
  Frontolateral craniotomy could be a practical alternative for patients with an unruptured intracranial aneurysm in the anterior circulation including the posterior communicating artery, particularly those who are in a medically poor state or who highly demand minimal aesthetic mutilation.
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jeyul
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chang Wan
authors.initials: CW
authors.lastname: Oh
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: O-Ki
authors.initials: OK
authors.lastname: Kwon
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Gyojun
authors.initials: G
authors.lastname: Hwang
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Tackeun
authors.initials: T
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jong Un
authors.initials: JU
authors.lastname: Moon
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Seong Yeol
authors.initials: SY
authors.lastname: Ahn
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jun Hak
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States.
authors.forename: Jinseong
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jae Seung
authors.identifier: 0000-0001-9543-8758
authors.initials: JS
authors.lastname: Bang
keywords: Clipping; Conventional pterional craniotomy; Frontolateral craniotomy; Minimal aesthetic mutilation; Temporal depression; Unruptured intracranial aneurysm