2025 Proffered Presentations
S382: SUPRAORBITAL KEY-HOLE APPROACH FOR INTRACRANIAL ANEURYSMS: TECHNIQUE AND FEASABILITY IN 54 CASES
Jose Carlos Rodrigues Jr, MD; Vithor Ely Bortolin da Silva, MD; Marcelo Ferraz de Campos, MD; Pedro Felipe Ferreira; Heliopolis Hospital
Introduction: Intracranial aneurysms treatment is one of the most common challenges in neurosurgery. Microsurgery remains as the most used approach specially in urgent cases. Nowadays, the use of minimally invasive approaches has revolutionized the surgery of intracranial diseases. Supraorbital key-hole access permits a great visualization of the anterior skull base and its contents being rational to apply it in intracranial aneurysm surgeries. Our series demonstrate that this approach is feasible for intracranial aneurysms with good results.
Objective: Illustrate a single institution (Heliopolis Hospital, Brazil) experience with the supraorbital key-hole approach for the treatment of intracranial aneurysms.
Methods: We retrospectively review our data base from January 2019 to August 2023 from cases of patients with intracranial aneurysms submitted to surgical procedure through supraorbital key-hole approach. Information concerned about age, gender, procedure date, localization, side of the surgery, aesthetic result and complications were gathered and analyzed. Results were demonstrated accordingly and compared with literature.
Results: From January 2019 to August 2023, we performed 103 cases using the supraorbital key-hole approach including 54 cases of intracranial aneurysms (52%). 94.4% (51) of the cases were ruptured. Both sides were approached equally (50% each). No intraoperative rupture occurred. In all cases we could correctly apply the clip to the aneurysm neck. No complications related to the approach were permanent. From the temporary ones, most common was periocular edema in 43 cases (80%) and frontal hypoesthesia in 12 cases (22.2%). No CSF fistula was observed in this series.
Conclusion: Surgical treatment of intracranial aneurysms remains as one of the toughest challenges in neurosurgery. With the technology and anatomical evolution, minimally invasive techniques are becoming useful to different brain pathologies. Our series demonstrated clearly that one of them, the supraorbital hey-hole approach, is feasible and safe for the clipping of intracranial aneurysms.