The supraorbital endoscopic approach for tumors.

Abstract

The supraorbital eyebrow craniotomy is being increasingly used for the removal of frontal fossa, parasellar, as well as some middle and posterior fossa tumors. The indications, technical nuances, and complication avoidance techniques for the supraorbital keyhole approach with endoscopic assistance are described. The supraorbital approach is considered ideal for removal of many, if not most, planum and tuberculum sellae meningiomas, some olfactory groove meningiomas, as well as suprasellar craniopharyngiomas, particularly those with far lateral extensions. It is also ideal for many intra-axial tumors, including metastases and gliomas arising from the orbitofrontal, frontal pole, and medial temporal lobe regions. The use of endoscopy further extends the range and versatility of this keyhole approach and is considered an essential adjunct for allowing safe and maximal tumor removal. The supraorbital eyebrow craniotomy with endoscopic assistance provides minimally invasive access to a wide range of frontal fossa, parasellar, and some middle and posterior fossa tumors.