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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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Surgical outcome and patient's satisfaction after supraorbital craniotomy through an eyebrow skin incision

Meeting Abstract

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  • Robert Reisch - Zentrum für endoskopische und minimalinvasive Neurochirurgie, Klinik Hirslanden Zürich
  • Michael Hugelshofer - Zentrum für endoskopische und minimalinvasive Neurochirurgie, Klinik Hirslanden Zürich; Institut für Pathologie, Universitätsspital Zürich
  • Hani Marcus - Zentrum für endoskopische und minimalinvasive Neurochirurgie, Klinik Hirslanden Zürich; Imperial College Healthcare NHS Trust, London, United Kingdom
  • Ralf Kockro - Zentrum für endoskopische und minimalinvasive Neurochirurgie, Klinik Hirslanden Zürich

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMI.16.04

doi: 10.3205/13dgnc419, urn:nbn:de:0183-13dgnc4190

Published: May 21, 2013

© 2013 Reisch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: The supraorbital approach through an eyebrow skin incision offers the opportunity to access a wide range of lesions of the anterior, middle and even the posterior fossa. The minimally invasive keyhole craniotomy limits brain exploration and retraction with the potential for improved surgical outcome and reduced approach-related complications; however, patient satisfaction has not yet reported in the literature.

Method: Between January 2002 and December 2011, the supraorbital approach through an eyebrow skin incision was utilized by the lead author (RR) in 418 cases comprising cerebral aneurysms, brain tumors or cystic lesions, and other miscellaneous pathologies. A detailed retrospective case note review was carried out in 408 patients to extract data on surgical outcome and complications, with a follow-on patient satisfaction questionnaire in 375 patients.

Results: Eight patients died during the early perioperative period (overall mortality 2.0%). The 30-day postoperative GOS for the remaining very heterogeneous group of patients were as follows: 5 in 358 (87.7%), 4 in 33 (8.1%), 3 in 8 (2.0%) and 2 in 1 patient (0.2%). The overall level of satisfaction was high in those patients subsequently surveyed. Scar-pain and headache were determined by patients on a scale from 1 to 5 (1= no pain, 5= severe pain) as follows: 1 in 289 (77.0%), 2 in 46 (12.3%), 3 in 22 (5.9%), 4 in 12 (3.2%) and 5 in 6 patients (1.6%). Postoperative cosmetic outcome was determined by patients on a scale from 1 to 5 (1= very pleasant, 5= very unpleasant) as follows: 1 in 315 (84.0%), 2 in 33 (8.8%), 3 in 14 (3.7%), 4 in 10 (2.7%) and 5 in 3 patients (0.8%). Postoperative difficulty chewing was reported in 8 patients [8 temporary (2.1%), 0 permanent]; palsy of the frontalis muscle in 21 patients (5.6%) [13 temporary (3.5%), 8 permanent (2.1%)]; frontal hypoesthesia in 31 patients (8.3%) [18 temporary (4.8%), 13 permanent (3.4%)]; and hyposmia in 11 patients (2.9%) [3 temporary (0.8%), 8 permanent (2.1%)].

Conclusions: The supraorbital approach through an eyebrow skin incision offers an acceptable rate of surgical complications with high patient satisfaction.