{"id":"3300ae43-ac29-4f90-9092-133ecd34c389","slug":"the-classical-supraorbital-minicraniotomy-to-approach-the-areas-of-origin-of-anterior-skull-base-meningiomas-anatomical-nuances-influencing-accessibility-operability-and-frontal-lobe-retraction","title":"The classical supraorbital minicraniotomy to approach the areas of origin of anterior skull base meningiomas: Anatomical nuances influencing accessibility, operability, and frontal lobe retraction","authors":["Lucas Serrano Sponton","Eleftherios Archavlis","Jens Conrad","Amr Nimer","Ali Ayyad","Elke Januschek","Daniel Jussen","Marcus Czabanka","Sven Schumann","Sven Kantelhardt"],"abstract":"Background: The classical supraorbital minicraniotomy (cSOM) constitutes a minimally invasive alternative for the resection of anterior skull base meningiomas (ASBM). Surgical success depends strongly on optimal patient selection and surgery planning, for which a careful assessment of tumor characteristics, approach trajectory, and bony anterior skull base anatomy is required. Still, morphometrical studies searching for relevant anatomical factors with surgical relevance when intending a cSOM for ASBM resection are lacking. Methods: Bilateral cSOM was done in five formaldehyde-fixed heads toward the areas of origin of ASBM. Morphometrical data with potential relevant surgical implications were analyzed. Results: The more tangential position of the cSOM with respect to the olfactory groove (OG) led to a reduction in surgical freedom (SF) in this area compared to others (P P P P P < 0.01). Conclusion: Although clinical validation is still needed, the present anatomical data suggest that assessing minicraniotomy’s position/extension, OG depth, the sphenoid’s slope, and distance to ACP-tip might be of particular relevance to predict FLR, maneuverability, and accessibility when considering the cSOM for ASBM resection, thus helping surgeons optimize patient selection and surgical strategy.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/3300ae43-ac29-4f90-9092-133ecd34c389/featured/hero-1781559518847.png","publishDate":"2024-05-24T00:00:00.000Z","doi":"10.25259/SNI_107_2024","categories":["Skull Base","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2024/05/12911/SNI-15-168.pdf"}