title: Contralateral supraorbital keyhole approach to medial optic nerve lesions: an anatomoclinical study.
abstract: OBJECTIVE The authors describe the supraorbital keyhole approach to the contralateral medial optic nerve and tract, both in a series of cadaveric dissections and in 2 patients. They also discuss the indications and contraindications for this procedure. METHODS In 3 cadaver heads, bilateral supraorbital keyhole minicraniotomies were performed to expose the ipsilateral and contralateral optic nerves. The extent of exposure of the medial optic nerve was assessed. In 2 patients, a contralateral supraorbital keyhole approach was used to remove pathology of the contralateral medial optic nerve and tract. RESULTS The supraorbital keyhole craniotomy provided better exposure of the contralateral superomedial nerve than it did of the same portion of the ipsilateral nerve. In both patients gross-total resections of the pathology was achieved. CONCLUSIONS The authors demonstrate the suitability of the contralateral supraorbital keyhole approach for lesions involving the superomedial optic nerve.
authors.affiliation: Department of Neurosurgery, Stanford University School of Medicine, Stanford, California;
authors.forename: Harminder
authors.initials: H
authors.lastname: Singh
authors.affiliation: Department of 2 Neurosurgery, Weill Cornell Medical College, NewYork-Presbyterian.
authors.forename: Walid I
authors.initials: WI
authors.lastname: Essayed
authors.affiliation: Department of 2 Neurosurgery, Weill Cornell Medical College, NewYork-Presbyterian.
authors.forename: Ajit
authors.initials: A
authors.lastname: Jada
authors.affiliation: Department of 2 Neurosurgery, Weill Cornell Medical College, NewYork-Presbyterian.|Division of Neurological Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; and.
authors.forename: Nelson
authors.initials: N
authors.lastname: Moussazadeh
authors.affiliation: Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sivashanmugam
authors.initials: S
authors.lastname: Dhandapani
authors.affiliation: Department of 2 Neurosurgery, Weill Cornell Medical College, NewYork-Presbyterian.
authors.forename: Sarang
authors.initials: S
authors.lastname: Rote
authors.affiliation: Department of 2 Neurosurgery, Weill Cornell Medical College, NewYork-Presbyterian.
authors.forename: Theodore H
authors.initials: TH
authors.lastname: Schwartz
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D009900:Optic Nerve / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D009901:Optic Nerve Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
keywords: anatomy; contralateral supraorbital keyhole approach; craniotomy; medial optic nerve lesion; minimally invasive; optic nerve decompression