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Minimally Invasive Surgery
Volume 2013, Article ID 296469, 11 pages
http://dx.doi.org/10.1155/2013/296469
Review Article

The Supraorbital Keyhole Craniotomy through an Eyebrow Incision: Its Origins and Evolution

Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA 30322, USA

Received 25 January 2013; Revised 15 May 2013; Accepted 9 June 2013

Academic Editor: Joachim Oertel

Copyright © 2013 D. Ryan Ormond and Costas G. Hadjipanayis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In the modern era of neurosurgery, the use of the operative microscope, rigid rod-lens endoscope, and neuronavigation has helped to overcome some of the previous limitations of surgery due to poor lighting and anatomic localization available to the surgeon. Over the last thirty years, the supraorbital craniotomy and subfrontal approach through an eyebrow incision have been developed and refined to play a legitimate role in the armamentarium of the modern skull base neurosurgeon. With careful patient selection, the supraorbital “keyhole” approach offers a less invasive but still efficacious approach to a number of lesions along the subfrontal corridor. Well over 1000 cases have been reported in the literature utilizing this approach establishing its safety and efficacy. This paper discusses the nuances of this approach, including the benefits and limitations of its use described through our technique, review of the literature, and case illustration.