title: Minimally Invasive Supraorbital Key-hole Approach for the Treatment of Anterior Cranial Fossa Meningiomas.
abstract: The most important target of minimally invasive surgery is to obtain the best therapeutic effect with the least iatrogenic injury. In this background, a pivotal role in contemporary neurosurgery is played by the supraorbital key-hole approach proposed by Perneczky for anterior cranial base surgery. In this article, it is presented as a possible valid alternative to the traditional craniotomies in anterior cranial fossa meningiomas removal. From January 2008 to January 2012 at our department 56 patients underwent anterior cranial base meningiomas removal. Thirty-three patients were submitted to traditional approaches while 23 to supraorbital key-hole technique. A clinical and neuroradiological pre- and postoperative evaluation were performed, with attention to eventual complications, length of surgical procedure, and hospitalization. Compared to traditional approaches the supraorbital key-hole approach was associated neither to a greater range of postoperative complications nor to a longer surgical procedure and hospitalization while permitting the same lesion control. With this technique, minimization of brain exposition and manipulation with reduction of unwanted iatrogenic injuries, neurovascular structures preservation, and a better aesthetic result are possible. The supraorbital key-hole approach according to Perneckzy could represent a valid alternative to traditional approaches in anterior cranial base meningiomas surgery.
authors.affiliation: Department of Neurosurgery, Università Politecnica delle Marche, Umberto I General Hospital.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Iacoangeli
authors.forename: Niccolò
authors.initials: N
authors.lastname: Nocchi
authors.forename: Davide
authors.initials: D
authors.lastname: Nasi
authors.forename: Alessandro
authors.initials: A
authors.lastname: DI Rienzo
authors.forename: Mauro
authors.initials: M
authors.lastname: Dobran
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gladi
authors.forename: Roberto
authors.initials: R
authors.lastname: Colasanti
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Alvaro
authors.forename: Gabriele
authors.initials: G
authors.lastname: Polonara
authors.forename: Massimo
authors.initials: M
authors.lastname: Scerrati
mesh_terms: D000368:Aged; D035262:Cranial Fossa, Anterior / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008579:Meningioma / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D019635:Neurosurgical Procedures; D016896:Treatment Outcome