The supraorbital keyhole approach: how I do it.

Abstract

Improvements in image guidance, endoscopy, and instruments, have significantly advanced "keyhole" neurosurgery. We describe the concept and technique of the supraorbital keyhole approach. The supraorbital keyhole approach is performed through an eyebrow skin incision. Image guidance may be used to define the optimal surgical trajectory. A limited supraorbital craniotomy is fashioned. The frontal lobe is mobilized and the central skull base approached, without the need for brain retractors. Endoscopy is used to enhance visualization, and tube-shaft instruments to improve manipulation through the narrow surgical corridor. The supraorbital keyhole approach provides a safe method to access selected skull base lesions.