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Endoscopic Assisted Eyebrow Craniotomy for Anterior Cranial Fossa Lesions: Clinical and Cosmetic Outcomes

Open Journal of Modern Neurosurgery 2024年第1期14卷 30-47页

作者： Ahmed Hosameldin Hesham Elshetany ehab abdelhalim Department of Neurosurgery Faculty of Medicine Fayoum University Fayoum Egypt Department of Neurosurgery Faculty of Medicine Cairo University Cairo Egypt

Background: The eyebrow supraorbital keyhole approach could be considered a modified minimally invasive model for the classic pterional subfrontal approach in which an eyebrow incision and supraorbital mini craniotomy are performed for exposure of the anterior cranial fossa corridor. Methods: This study was retrospectively conducted on twenty four patients, age ranging from 20 to 65 years old, with anterior cranial fossa lesions who were meeting the eligibility criteria for eyebrow craniotomy in the period from August 2019 to January 2023. These patients were operated through eyebrow supraorbital approach in which microscopic endoscopic assisted technique were used. Extent of resection, clinical and cosmetic outcomes and complication incidence were assessed. Results: We included the twenty four patients who met inclusion criteria (17 females and 7 males) their ages ranged from 20 to 65 years. The most common pathology was meningioma in 19 patients. Two patients experienced supraorbital loss of sensation and only one patient experienced palsy of frontalis branch of facial nerve. Frontal sinus was breached in 3 patients with no patient experienced postoperative CSF leak. Total excision was accomplished for 23 patients. Four patients who had preoperative visual compromise, improvement of visual acuity and field defects was observed in 3 patients. No major intraoperative complications occurred. All patients filled cosmetic satisfaction questionnaire during their outpatient visits. For the eyebrow supraorbital approach, no incision related intolerable pain, no craniotomy defects or irregularities, no cosmetic complaints nor limitation of jaw opening were reported, and only minor symptoms in the form of limited eyebrow elevation, swelling and numbness in the forehead. Conclusions: The eyebrow craniotomy could be used safely as a more cosmetic and minimally invasive approach for a variety of anterior cranial fossa lesions. Endoscopic assistance has been found very useful f

关键词： Eyebrow Supraorbital Approach Keyhole Craniotomy Microscopic Endoscopic Minimally Invasive

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Minimally Invasive 360 Degrees Decompression for Ligamentous, Bony and Discogenic Lumbar Canal Stenosis

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Open Journal of Modern Neurosurgery 2023年第3期13卷 111-120页

作者： Ahmed Hosameldin Hussein Abdelhamid Hesham Elshetany Mostafa Abdellatif ehab abdelhalim Department of Neurosurgery Faculty of Medicine Fayoum University Fayoum Egypt Department of Neurosurgery Faculty of Medicine Cairo University Cairo Egypt

Background: For decades, traditional open surgical techniques were used to treat lumbar disc herniation and lumbar canal stenosis (LCS). However, seeking for better outcomes for patients and avoiding extensive bony loss with its sequences had raised minimally invasive technique for treating these disorders as an alternative surgery. Methods: This is a retrospective study in which 54 patients of LCS were operated upon via unilateral minimally invasive technique to decompress the canal in a 360 degrees fashion through laminotomy, deroofing of opposite laminar side, sublaminar ligamintectomy, bilateral foraminotomies and discectomy. We used VAS scores and ODI to assess clinical outcomes with a period of one year follow-up. Results: Our results demonstrated that minimally invasive techniques for treating these disorders are effective procedures. Minimally invasive 360 degrees decompression for treating LCS had better outcomes regarding postoperative back pain, smaller incisions, less bony loss and early ambulation. Conclusion: Minimally invasive techniques for treating lumbar canal stenosis of different causes could be considered a better option instead of traditional full laminectomy with better outcomes as regards respecting the anatomical layers such as posterior spinal integrity and musculature, postoperative pain, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods.

关键词： Lumbar Decompression Minimally Invasive Surgery 360 Degrees Lumbar Canal Stenosis

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