Transpalpebral approach in skull base surgery: how I do it

Abstract

Background

Keyhole surgery has been actively developing in the last two decades. Modern neuroimaging, preoperative individual planning, and innovative neurosurgical equipment allow us to operate through mini craniotomy with minimization of approach-related complications.

Method

Preoperative planning is very critical. After the patient positioning, skin incision, craniotomy, and dura incision are performed. Intradural lesion is reached with standard microneurosurgical technique. A watertight dura closure is important.

Conclusion

Transpalpebral approach can be good alternative to traditional, extended fronto-lateral craniotomies with excellent cosmetic and functional outcomes. Adequate selection of patients is important.

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Authors

Corresponding author

Correspondence to Andrey Victorovich Polyakov.

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The authors declare that they have no conflict of interest.

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The patients have consented to the submission of this How I Do It for submission to the journal.

Additional information

This article is part of the Topical Collection on Vascular Neurosurgery - Aneurysm

Electronic supplementary material

File « Transpalpebral approach example (Part 1) »: example of transpalpebral approach from skin incision to craniotomy (MP4 334684 kb)

File « Left ICA aneurysm clipping, TPA (Part 2) »: video shows left internal carotid artery aneurysm clipping through transpalpebral approach (MP4 391438 kb)

Video 1

File « Transpalpebral approach example (Part 1) »: example of transpalpebral approach from skin incision to craniotomy (MP4 334684 kb)

Video 2

File « Left ICA aneurysm clipping, TPA (Part 2) »: video shows left internal carotid artery aneurysm clipping through transpalpebral approach (MP4 391438 kb)

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Dzhindzhikhadze, R.S., Dreval, O.N., Lazarev, V.A. et al. Transpalpebral approach in skull base surgery: how I do it. Acta Neurochir 161, 133–137 (2019). https://doi.org/10.1007/s00701-018-3724-4

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Keywords

  • Keyhole
  • Transpalpebral approach
  • Cerebral aneurysms
  • Skull base surgery
  • Minimally invasive neurosurgery