Skip to main content
Top
Published in: Neurosurgical Review 1/2020

01-02-2020 | Meningioma | Original Article

Lateral supraorbital versus pterional approach for parachiasmal meningiomas: surgical indications and esthetic benefits

Authors: Hun Ho Park, Kyoung Su Sung, Ju Hyung Moon, Eui Hyun Kim, Sun Ho Kim, Kyu-Sung Lee, Chang-Ki Hong, Jong Hee Chang

Published in: Neurosurgical Review | Issue 1/2020

Login to get access

Abstract

The lateral supraorbital (LSO) approach is a minimally invasive modification of the pterional approach. The authors assess the surgical indications and esthetic benefits of the LSO approach in comparison with the pterional approach for parachiasmal meningiomas. From April 2013 to May 2017, a total of 64 patients underwent surgery for parachiasmal meningiomas. Among them, tumor resection was performed with the LSO approach for 34 patients and pterional approach for 30 patients. A retrospective analysis was done on tumor characteristics, surgical outcome, approach-related morbidity, and esthetic outcome between the two approaches. Gross total resection was achieved in 33 of 34 patients (97.1%) with the LSO approach. There were no differences in tumor size, origin, consistency, internal carotid artery encasement, cranial nerve adhesion, and optic canal invasion between the two approaches. The most common tumor origin was the tuberculum sellae for both the LSO and pterional approaches. For tumors with preoperative visual compromise, immediate visual outcome improved or remained stable in 76% and 80.9% with the LSO and pterional approaches, respectively. Surgery time, surgical bleeding, hospital length of stay, and esthetic outcome were significantly shorter and superior with the LSO approach. There were no differences in surgical morbidity and brain retraction injury between the two approaches. The LSO approach can provide a safe, rapid, and minimally invasive exposure for parachiasmal meningiomas compared with the pterional approach. Surgeons must consider tumor size, origin, and extent in determining the resectability of the tumor rather than the extent of exposure.
Literature
1.
go back to reference Ammirati M, Spallone A, Ma J, Cheatham M, Becker D (1994) Preservation of the temporal branch of the facial nerve in pterional-transzygomatic craniotomy. Acta Neurochir 128:163–165CrossRef Ammirati M, Spallone A, Ma J, Cheatham M, Becker D (1994) Preservation of the temporal branch of the facial nerve in pterional-transzygomatic craniotomy. Acta Neurochir 128:163–165CrossRef
2.
go back to reference Andaluz N, Romano A, Reddy LV, Zuccarello M (2008) Eyelid approach to the anterior cranial base. J Neurosurg 109:341–346CrossRef Andaluz N, Romano A, Reddy LV, Zuccarello M (2008) Eyelid approach to the anterior cranial base. J Neurosurg 109:341–346CrossRef
3.
go back to reference Aydin IH, Takci E, Kadioglu HH, Kayaoglu CR, Tuzun Y (1995) Pitfalls in the pterional approach to the parasellar area. Minim Invasive Neurosurg 38:146–152CrossRef Aydin IH, Takci E, Kadioglu HH, Kayaoglu CR, Tuzun Y (1995) Pitfalls in the pterional approach to the parasellar area. Minim Invasive Neurosurg 38:146–152CrossRef
4.
go back to reference Badie B (1996) Cosmetic reconstruction of temporal defect following pterional craniotomy. Surg Neurol 45:383–384CrossRef Badie B (1996) Cosmetic reconstruction of temporal defect following pterional craniotomy. Surg Neurol 45:383–384CrossRef
5.
go back to reference Barone CM, Jimenez DF, Boschert MT (2001) Temporalis muscle resuspension using titanium miniplates and screws: technical note. Neurosurgery 48:450–451PubMed Barone CM, Jimenez DF, Boschert MT (2001) Temporalis muscle resuspension using titanium miniplates and screws: technical note. Neurosurgery 48:450–451PubMed
6.
go back to reference Chen G, Wang Z, Zhou D (2013) Lateral supraorbital approach applied to sellar tumors in 23 consecutive patients: the Suzhou experience from China. World J Surg Oncol 21:11–41 Chen G, Wang Z, Zhou D (2013) Lateral supraorbital approach applied to sellar tumors in 23 consecutive patients: the Suzhou experience from China. World J Surg Oncol 21:11–41
7.
go back to reference Coscarella E, Vishteh AG, Spetzler RF, Seoane E, Zabramski JM (2000) Subfascial and submuscular methods of temporal muscle dissection and their relationship to the frontal branch of the facial nerve. Technical note. J Neurosurg 92:877–880CrossRef Coscarella E, Vishteh AG, Spetzler RF, Seoane E, Zabramski JM (2000) Subfascial and submuscular methods of temporal muscle dissection and their relationship to the frontal branch of the facial nerve. Technical note. J Neurosurg 92:877–880CrossRef
8.
go back to reference Dandy W (1938) Hirnchirurgie. Springer, Germany Dandy W (1938) Hirnchirurgie. Springer, Germany
9.
go back to reference Dandy W (1938) Intracranial aneurysm of the internal carotid artery. Cured by operation. Ann Surg 107:654–659CrossRef Dandy W (1938) Intracranial aneurysm of the internal carotid artery. Cured by operation. Ann Surg 107:654–659CrossRef
10.
go back to reference de Andrade FC Jr, de Andrade FC, de Araujo Filho CM, Filho JC (1998) Dysfuntion of the temporalis muscle after pterional craniotomy for intracranial aneurysms. Comparative, prospective and randomized study of one flap versus two flaps dieresis. Arq Neuropsiquiatr 56:200–205CrossRef de Andrade FC Jr, de Andrade FC, de Araujo Filho CM, Filho JC (1998) Dysfuntion of the temporalis muscle after pterional craniotomy for intracranial aneurysms. Comparative, prospective and randomized study of one flap versus two flaps dieresis. Arq Neuropsiquiatr 56:200–205CrossRef
11.
go back to reference Figueiredo EG, Deshmukh P, Zabramski JM, Preul MC, Crawford NR, Spetzler RF (2006) The pterional-transsylvian approach: an analytical study. Neurosurgery 59(4 Suppl 2):ONS263–ONS269PubMed Figueiredo EG, Deshmukh P, Zabramski JM, Preul MC, Crawford NR, Spetzler RF (2006) The pterional-transsylvian approach: an analytical study. Neurosurgery 59(4 Suppl 2):ONS263–ONS269PubMed
12.
go back to reference Figueiredo EG, Deshmukh P, Nakaji P, Crusius MU, Crawford N, Spetzler RF, Preul MC (2007) The minipterional craniotomy: technical description and anatomic assessment. Neurosurgery 61:256–264PubMed Figueiredo EG, Deshmukh P, Nakaji P, Crusius MU, Crawford N, Spetzler RF, Preul MC (2007) The minipterional craniotomy: technical description and anatomic assessment. Neurosurgery 61:256–264PubMed
13.
go back to reference Harland SP, Hussein A, Gullan RW (1996) Modification of the standard pterional approach for aneurysms of the anterior circle of Willis. Br J Neurosurg 10:149–153CrossRef Harland SP, Hussein A, Gullan RW (1996) Modification of the standard pterional approach for aneurysms of the anterior circle of Willis. Br J Neurosurg 10:149–153CrossRef
14.
go back to reference Hernesniemi J, Ishii K, Niemela M, Smrcka M, Kivipelto L, Fikiki M, Shen H (2005) Lateral supraorbital approach as an alternative to the classical pterional approach. Acta Neurochir Suppl 94:17–21CrossRef Hernesniemi J, Ishii K, Niemela M, Smrcka M, Kivipelto L, Fikiki M, Shen H (2005) Lateral supraorbital approach as an alternative to the classical pterional approach. Acta Neurochir Suppl 94:17–21CrossRef
15.
go back to reference Hwang SW, Abozed MM, Antoniou AJ, Malek AM, Heilman CB (2010) Postoperative temporalis muscle atrophy and the use of electrocautery: a volumetric MRI comparison. Skull Base 20:321–326CrossRef Hwang SW, Abozed MM, Antoniou AJ, Malek AM, Heilman CB (2010) Postoperative temporalis muscle atrophy and the use of electrocautery: a volumetric MRI comparison. Skull Base 20:321–326CrossRef
16.
go back to reference Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2012) Endoscopic endonasal versus open transcranial resection of anterior midline skull base meningiomas. World Neurosurg 77:713–724CrossRef Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2012) Endoscopic endonasal versus open transcranial resection of anterior midline skull base meningiomas. World Neurosurg 77:713–724CrossRef
17.
go back to reference Koutourousiou M, Fernandez-Miranda JC, Stefko ST, Wang EW, Snyderman CH, Gardner PA (2014) Endoscopic endonasal surgery for suprasellar meningiomas: experience with 75 patients. J Neurosurg 120:1326–1339CrossRef Koutourousiou M, Fernandez-Miranda JC, Stefko ST, Wang EW, Snyderman CH, Gardner PA (2014) Endoscopic endonasal surgery for suprasellar meningiomas: experience with 75 patients. J Neurosurg 120:1326–1339CrossRef
18.
go back to reference Kulwin C, Schwartz TH, Cohen-Gadol AA (2013) Endoscopic extended transsphenoidal resection of tuberculum sellae meningiomas: nuances of neurosurgical technique. Neurosurg Focus 35(6):E6CrossRef Kulwin C, Schwartz TH, Cohen-Gadol AA (2013) Endoscopic extended transsphenoidal resection of tuberculum sellae meningiomas: nuances of neurosurgical technique. Neurosurg Focus 35(6):E6CrossRef
19.
go back to reference La Rocca G, Della Pepa GM, Sturiale CL, Sabatino G, Auricchio AM, Puca A, Olivi A, Marchese E, Albanese A (2018) Lateral supraorbital versus pterional approach: analysis of surgical, functional, and patient-oriented outcomes. World Neurosurg 119:e192–e199CrossRef La Rocca G, Della Pepa GM, Sturiale CL, Sabatino G, Auricchio AM, Puca A, Olivi A, Marchese E, Albanese A (2018) Lateral supraorbital versus pterional approach: analysis of surgical, functional, and patient-oriented outcomes. World Neurosurg 119:e192–e199CrossRef
20.
go back to reference Liu JK, Christiano LD, Patel SK, Tubbs RS, Eloy JA (2011) Surgical nuances for removal of olfactory groove meningiomas using the endoscopic endonasal transcribriform approach. Neurosurg Focus 30(5):E3CrossRef Liu JK, Christiano LD, Patel SK, Tubbs RS, Eloy JA (2011) Surgical nuances for removal of olfactory groove meningiomas using the endoscopic endonasal transcribriform approach. Neurosurg Focus 30(5):E3CrossRef
21.
go back to reference Park HH, Oh MC, Kim EH, Kim CY, Kim SH, Lee KS, Chang JH (2015) Use of optical coherence tomography to predict visual outcome in parachiasmal meningioma. J Neurosurg 123:1489–1499CrossRef Park HH, Oh MC, Kim EH, Kim CY, Kim SH, Lee KS, Chang JH (2015) Use of optical coherence tomography to predict visual outcome in parachiasmal meningioma. J Neurosurg 123:1489–1499CrossRef
22.
go back to reference Reisch R, Perneczky A, Filippi R (2003) Surgical technique of the supraorbital key-hole craniotomy. Surg Neurol 59:223–227CrossRef Reisch R, Perneczky A, Filippi R (2003) Surgical technique of the supraorbital key-hole craniotomy. Surg Neurol 59:223–227CrossRef
23.
go back to reference Romani R, Lehecka M, Gaal E, Toninelli S, Celik O, Niemela M, Porras M, Jaaskelainen J, Hernesniemi J (2009) Lateral supraorbital approach applied to olfactory groove meningiomas: experience with 66 consecutive patients. Neurosurgery 65:39–52CrossRef Romani R, Lehecka M, Gaal E, Toninelli S, Celik O, Niemela M, Porras M, Jaaskelainen J, Hernesniemi J (2009) Lateral supraorbital approach applied to olfactory groove meningiomas: experience with 66 consecutive patients. Neurosurgery 65:39–52CrossRef
24.
go back to reference Romani R, Laakso A, Kangasniemi M, Lehecka M, Hernesniemi J (2011) Lateral supraorbital approach applied to anterior clinoidal meningiomas: experience with 73 consecutive patients. Neurosurgery 68:1632–1647CrossRef Romani R, Laakso A, Kangasniemi M, Lehecka M, Hernesniemi J (2011) Lateral supraorbital approach applied to anterior clinoidal meningiomas: experience with 73 consecutive patients. Neurosurgery 68:1632–1647CrossRef
25.
go back to reference Romani R, Laakso A, Kangasniemi M, Niemelä M, Hernesniemi J (2012) Lateral supraorbital approach applied to tuberculum sellae meningiomas: experience with 52 consecutive patients. Neurosurgery 70:1504–1518CrossRef Romani R, Laakso A, Kangasniemi M, Niemelä M, Hernesniemi J (2012) Lateral supraorbital approach applied to tuberculum sellae meningiomas: experience with 52 consecutive patients. Neurosurgery 70:1504–1518CrossRef
26.
go back to reference Salma A, Alkandari A, Sammet S, Ammirati M (2011) Lateral supraorbital approach vs pterional approach: an anatomic qualitative and quantitative evaluation. Neurosurgery 68:364–372PubMed Salma A, Alkandari A, Sammet S, Ammirati M (2011) Lateral supraorbital approach vs pterional approach: an anatomic qualitative and quantitative evaluation. Neurosurgery 68:364–372PubMed
27.
go back to reference Welling LC, Figueiredo EG, Wen HT, Gomes MQ, Bor-Seng-Shu E, Casarolli C, Guirado VM, Teixeira MJ (2015) Prospective randomized study comparing clinical, functional, and aesthetis results of minipterional and class pterional craniotomies. J Neurosurg 122:1012–1019CrossRef Welling LC, Figueiredo EG, Wen HT, Gomes MQ, Bor-Seng-Shu E, Casarolli C, Guirado VM, Teixeira MJ (2015) Prospective randomized study comparing clinical, functional, and aesthetis results of minipterional and class pterional craniotomies. J Neurosurg 122:1012–1019CrossRef
28.
go back to reference Yasargil MG (1984) General operative techniques, in Yasargil MG (ed): microneurosurgery. New York. NY: Thieme-Stratton 1:208–233 Yasargil MG (1984) General operative techniques, in Yasargil MG (ed): microneurosurgery. New York. NY: Thieme-Stratton 1:208–233
29.
go back to reference Yasargil MG (1996) Meningiomas. In: Yasargil MG (ed) Microneurosurgery, vol 4B. Thieme, New York, pp 134–185 Yasargil MG (1996) Meningiomas. In: Yasargil MG (ed) Microneurosurgery, vol 4B. Thieme, New York, pp 134–185
30.
go back to reference Yasargil MG (1996) Surgical approaches. In: Yasargil MG (ed) Microneurosurgery, vol 4B. Thieme, New York, pp 29–68 Yasargil MG (1996) Surgical approaches. In: Yasargil MG (ed) Microneurosurgery, vol 4B. Thieme, New York, pp 29–68
31.
go back to reference Zumofen DW, Rychen J, Roethlisberger M, Taub E, Kalbermatten D, Nossek E, Potts M, Guzman R, Riina HA, Mariani L (2017) A review of the literature on the transciliary supraorbital keyhole approach. World Neurosurg 98:614–624CrossRef Zumofen DW, Rychen J, Roethlisberger M, Taub E, Kalbermatten D, Nossek E, Potts M, Guzman R, Riina HA, Mariani L (2017) A review of the literature on the transciliary supraorbital keyhole approach. World Neurosurg 98:614–624CrossRef
Metadata
Title
Lateral supraorbital versus pterional approach for parachiasmal meningiomas: surgical indications and esthetic benefits
Authors
Hun Ho Park
Kyoung Su Sung
Ju Hyung Moon
Eui Hyun Kim
Sun Ho Kim
Kyu-Sung Lee
Chang-Ki Hong
Jong Hee Chang
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
Neurosurgical Review / Issue 1/2020
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI
https://doi.org/10.1007/s10143-019-01147-8

Other articles of this Issue 1/2020

Neurosurgical Review 1/2020 Go to the issue