The Lateral Supra-Orbital Approach: A Minimally Invasive Keyhole Concept

Objective: The aim of this work is to study the indications, versatility, clinical and radiological results of the supraorbital approach in the treatment of different sellar and anterior cranial fossa lesions. The results will hopefully be guidance to the advantages, disadvantages and limitations of the approach.Methods: Pathological lesions involving the anterior cranial skull base, and the sellar region, are included. Lesions include different tumors, and developmental pathology. The patients will be evaluated and investigated preoperatively. The operative procedure will be evaluated and analyzed. The patients will be followed for evaluation of extent of resection, postoperative complication and outcome. The data will be analyzed to evaluate the efficiency of the lateral supraorbital approach. Results: In this study 15 cases were operated upon, by the supraorbital approach. There were a total of 6 males and 9 females, the ages of whom ranged from 3 years to 55 years. Various pathological lesions were treated. Total removal was achieved in 10 (66.5%) cases. Excellent outcome was achieved in 10 (66.5%) cases. Good outcome was possible in 4 (26.5%) cases with 1 (6.5%) case with poor outcome. Conclusion: The supraorbital approach is a safe approach that can be applied with good preoperative planning to lesions of the sellar area. Lesions extending into the middle cranial fossa or below the level of the sphenoid ridge or posterior clinoid should not be approached by the supraorbital approach. Lesions extending into the retrosellar area may be difficult to manipulate. Lesions extending high up to the third ventricle may be approached by the trans-supraorbital approach.