Stefano Signoretti, Lorenzo Pescatori, Barbara Nardacci, Alberto Delitala, Alois Zauner, Massimiliano Visocchi
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Supraorbital Keyhole Versus Pterional Approach: A Morphometric Anatomical Study.
Objective: Although the supraorbital (SO) keyhole approach has a wide range of indications, its routine usefulness with the advance of current technology has not been fully evaluated. In an attempt to address this issue, a cadaveric morphometric analysis to the supra- and parasellar regions was performed, comparing the standard Pterional craniotomy (PT) with the SO keyhole.
Methods: ETOH-fixed and silicone-injected human cadaveric heads were used. SO (n = 8) and PT craniotomies (n = 8) were performed. Pre- and post-dissection CT, along with pre-dissection MRI scans were also completed for neuro-navigation purposes, aimed to verify predetermined anatomical landmarks selected for morphometric analysis.
Results: Notwithstanding the smaller craniotomy, the SO approach allowed optimal anatomical exposure when compared to the PT approach. With 30° of head rotation, the SO keyhole showed a wider surgical field of the suprasellar region.
Conclusions: Using detailed preoperative image-guided surgical planning, the SO keyhole approach offered an appropriate alternative route to the supra- and parasellar regions, compared to the PT craniotomy.
期刊介绍：
In addition to the regular journal, "Acta Neurochirurgica" publishes 3-4 supplement volumes per year. These comprise proceedings of international meetings or other material of general neurosurgical interest.
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