Surgical experience with frontolateral keyhole craniotomy through a superciliary skin incision

OBJECTIVE: The purpose of this study was to evaluate the results of 173 fro ntolateral keyhole minicraniotomies performed on 155 patients with aneurysm s of the anterior or posterior cerebral circulation and for supratentorial tumors. METHODS: The frontolateral keyhole craniotomy is a modification of the gene rally used pterional approach. Of the 155 patients studied, 102 harbored sa ccular arterial aneurysms in the vessels of the anterior or posterior cereb ral circulation, and 53 had various tumors in the frontal base, suprasellar , or parasellar region. The operations were carried out through an approxim ately 2.5- x 3-cm frontolateral miniaturized craniotomy after a skin incisi on just above the eyebrow. RESULTS: Despite the small size of the craniotomy, the exploration allows e nough room for intracranial manipulation with maximal protection of the bra in and other intracranial structures. The presented series of patients did not have any craniotomy-related complications. CONCLUSION: In our experience, the frontolateral keyhole craniotomy, togeth er with the advent of the modern neuroanesthesia, cerebrospinal fluid drain age, and microsurgical techniques, is a safe approach for an experienced ne urosurgeon to use in the treatment of supratentorial aneurysms or tumors of the anterior fossa and sellar regions.