The supraorbital keyhole approach with an eyebrow incision for microsurgical treatment of lesions in the anterior skull base and sellar region

Objective To investigate the supraorbital keyhole approach with an eyebrow incision for microsurgical treatment of lesions in the anterior skull base and sellar region.Methods The skin incision through superciliary arch and an intra-frontal bone window(3.5 cm×2.5 cm) including orbital margin and part of orbital plate was performed.The tumors or aneurysms were treated by microsurgery and the endoscope was introduced when necessary.Results All 26 cases with lesions of the anterior skull base and sellar region were cured.Transient diabetes insipidus in 2 cases and electrolyte imbalance in 3 cases were successfully cured by medical treatment and hydrocephalus in 1 case was treated by ventriculoperitoneal shunt.No complication related to the surgical approach and no recurrence occurred during short-term follow-up.Conclusion The supraorbital keyhole approach with an eyebrow incision is a safe and effective surgical approach for the lesions of the anterior skull base and sellar region.It obviously reduces the injury because of minimal invasion and provides adequate surgical space in sellar region and effectively removes the lesions.Endoscope-assisted surgery can reduce the damage to nerves and blood vessels and increase the total resection rate of tumors.