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Candy NG, Van Der Veken J, Van Velthoven V. 'What's in a name', a systematic review of the pterional craniotomy for aneurysm surgery and its many modifications with a proposal for simplified nomenclature. Acta Neurochir (Wien) 2024; 166:11. [PMID: 38227061 DOI: 10.1007/s00701-024-05888-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/17/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND The pterional or frontosphenotemporal craniotomy has stood the test of time and continues to be a commonly used method of managing a variety of neurosurgical pathology. Already described in the beginning of the twentieth century and perfected by Yasargil in the 1970s, it has seen many modifications. These modifications have been a normal evolution for most neurosurgeons, tailoring the craniotomy to the patients' specific anatomy and pathology. Nonetheless, an abundance of variations have appeared in the literature. METHODS A search strategy was devised according to the 2020 Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) statement. To identify articles investigating the variations in the pterional approach, the following search terms were applied: (pterional OR minipterional OR supraorbital) AND (approach OR craniotomy OR technique). RESULTS In total, 3552 articles were screened with 74 articles being read in full with 47 articles being included for review. Each article was examined according the name of the technique, temporalis dissection technique, craniotomy technique and approach. CONCLUSION This systematic review gives an overview of the different techniques and modifications to the pterional craniotomy since it was initially described. We advocate for the use of a more standardised nomenclature that focuses on the target zone to simplify the management approach to supratentorial aneurysms.
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Affiliation(s)
- Nicholas G Candy
- Department of Surgery - Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Research, Woodville South, Adelaide, Australia.
- Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, Australia.
| | - Jorn Van Der Veken
- Department of Neurosurgery, Aalsters Stedelijk Ziekenhuis, Merestraat 80, 9300, Aalst, Belgium
| | - Vera Van Velthoven
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Jette, Belgium
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Stonnington HO, Turcotte EL, Di Nome MA, Lettieri SC, Mrugala MM, Porter AB, Bendok BR. Commentary: Transorbital Endoscopic Eyelid Approach for Resection of Spheno-Orbital Meningioma: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2022; 23:e195-e196. [PMID: 35972113 DOI: 10.1227/ons.0000000000000342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Henry O Stonnington
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA.,Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA
| | - Evelyn L Turcotte
- Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.,Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA.,Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA
| | - Marie A Di Nome
- Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona, USA
| | | | | | - Alyx B Porter
- Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA
| | - Bernard R Bendok
- Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.,Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA.,Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.,Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA.,Department of Radiology, Mayo Clinic, Phoenix, Arizona, USA
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Bertani R, Koester S, Batista S, Perret C, Bocanegra-Becerra JE, Maria PS, Gallo BHD, Abi-Aad K, Ferrarez CE, Rabelo NN, Von Zuben D, Do Espirito Santo MP, Figueiredo EG. Minimally invasive craniotomies for lesions of the anterior and middle fossa. Neurosurg Rev 2022; 45:3149-3156. [PMID: 35994128 DOI: 10.1007/s10143-022-01850-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/26/2022] [Accepted: 08/15/2022] [Indexed: 11/24/2022]
Abstract
Minimally invasive craniotomies are the subject of increasing attention over the last two decades in neurosurgery, following the current trend of attempting to increase patient safety by providing surgeries with less tissue disruption, blood loss, and decreased operative time. However, a significant information overlap exists among the various keyhole approaches regarding their indications and differences with more invasive techniques. Therefore, the present study aims to comprehensively review, illustrate, and describe the potential benefits and disadvantages of minimally invasive techniques to access the anterior and middle fossa, including the mini-pterional, mini orbito-zygomatic, supraorbital, lateral supraorbital, and extended lateral supraorbital approaches while comparing them to classic, more invasive approaches.
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Affiliation(s)
- Raphael Bertani
- Department of Neurosurgery, University of São Paulo, São Paulo, Brazil.
| | - Stefan Koester
- School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Sávio Batista
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caio Perret
- Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil
| | | | - Paulo Santa Maria
- Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil
| | | | | | | | | | - Daniela Von Zuben
- Department of Neurosurgery, University of São Paulo, São Paulo, Brazil
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Martinez-Perez R, Beer-Furlan A, Albonette-Felicio T, Hardesty DA, Mohyeldin A, Hara T, Carrau RL, Prevedello DM. The transsylvian corridor through minimally invasive transcranial approaches: a comparative anatomical study. Neurosurg Rev 2020; 44:2619-2627. [PMID: 33210182 DOI: 10.1007/s10143-020-01439-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/17/2020] [Accepted: 11/11/2020] [Indexed: 11/29/2022]
Abstract
Minimally invasive transcranial approaches (MITAs) continue to expand in popularity in neurosurgery. Only few MITAs allow sufficient sylvian exposure to enable wide use of the transsylvian corridor. In this study, we aim to compare the transsylvian corridor in two MITAs: the minipterional (MPTa) and the extended supraorbital eyebrow approaches (XSEa). Eight cadaver heads were used to quantify the surgical exposure and maneuverability along the sylvian fissure and the insular lobe provided by the MPTa and the XSEa. Surgical exposure was calculated by means of the exposed length of the sylvian fissure and by the area framed within three extreme points in the insular lobe. Maneuverability was assessed by means of the surgical freedom along the sylvian cistern. XSEa provides twice the frontal exposure and half of the temporal exposure in comparison to the MPTa (p < 0.001 and p = 0.02, respectively). No significant differences were found between the two craniotomies in the length of the exposure of the sylvian fissure, area of insular exposure, or surgical freedom. Both the MPTa and the XSEa afford sufficient grades of exposure along the sylvian fissure and the insular lobe, although the viewing angle is significantly different between the two approaches. Such properties allow either to be used for microsurgery deep within the sylvian cistern. The use of additional corridors, such as the subfrontal route (XSEa) and pretemporal route (MPTa), may influence selection of either the minipterional or the extended supraorbital approaches according to the origin of the surgical pathology addressed.
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Affiliation(s)
- Rafael Martinez-Perez
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, 410 W 10th Ave, Columbus, OH, 43210, USA.
| | | | - Thiago Albonette-Felicio
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, 410 W 10th Ave, Columbus, OH, 43210, USA
| | - Douglas A Hardesty
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, 410 W 10th Ave, Columbus, OH, 43210, USA.,Department of Head and Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Ahmed Mohyeldin
- Department of Neurosurgery, Stanford University, Palo Alto, CA, USA
| | - Takuma Hara
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, 410 W 10th Ave, Columbus, OH, 43210, USA
| | - Ricardo L Carrau
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, 410 W 10th Ave, Columbus, OH, 43210, USA.,Department of Head and Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Daniel M Prevedello
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, 410 W 10th Ave, Columbus, OH, 43210, USA. .,Department of Head and Neck Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
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