Suprapterional keyhole approach for anteromedial skull base lesions: How I do it

Acta Neurochir (Wien). 2024 Jul 31;166(1):311. doi: 10.1007/s00701-024-06202-y.

Abstract

Background: For a minimally invasive treatment approach to the anteromedial part of the anterior cranial fossa (ACF), a small incision and craniotomy of the posterolateral part of the ACF are preferable.

Method: We described the concept and technique of suprapterional keyhole approach (SPKA), which uses an exoscope and endoscope to treat ACF lesions.

Conclusion: The SPKA enables ACF observation from the lateral direction; the endoscope's extended viewing angles enable the observation of the anteromedial part of the ACF, including the bilateral olfactory groove. Facial skin and large scalp incisions are avoided, making this approach efficient for ACF lesions.

Keywords: Anterior cranial fossa; Endoscope; Exoscope; Olfactory groove; Planum sphenoidale; Suprapterional keyhole.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cranial Fossa, Anterior* / surgery
  • Craniotomy* / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Neurosurgical Procedures / methods
  • Skull Base / diagnostic imaging
  • Skull Base / surgery
  • Skull Base Neoplasms* / diagnostic imaging
  • Skull Base Neoplasms* / surgery