Abstract
We compared the surgical efficacy of the supraorbital key-hole approach (SKA) to conventional unilateral frontotemporal craniotomy (UFTC) for the treatment of patients with unilateral-dominant bilateral frontal contusions (BFCs). A retrospective analysis of 62 patients with unilateral-dominant BFCs who underwent surgery at our institute between 2014 and 2017 was performed. There were 26 patients who underwent SKA (group A) and 36 who underwent UFTC (group B). Postoperative computed tomography scans showed satisfactory evacuation of the frontal cerebral contusions in both groups (p > 0.05). There was less intraoperative blood loss in group A than group B (17.1 ± 4.55 vs. 67.6 ± 10.28 mL, p < 0.05). The operative time was also shorter in group A (82.7 ± 13.73 vs. 132.4 ± 9.17 min, p < 0.05). Postoperative bleeding occurred in three cases in group A and in only one case in group B (p > 0.05). The average length of hospitalization was shorter in group A than group B (7.3 ± 1.09 vs. 12.9 ± 1.71 days, p < 0.05). No differences in the Glasgow Outcome Scale were observed between the two groups after 6 months of follow-up (p > 0.05). Thus, compared to UFTC, SKA is associated with shorter operation times and less trauma to the surrounding brain tissue.
Highlights
A bilateral frontal contusion (BFC) is a common traumatic brain injury in clinical practice [1]
We first assessed the clinical features of patients treated with the supraorbital key-hole approach (SKA) or conventional unilateral frontotemporal craniotomy (UFTC)
No significant differences between the two groups were observed in routine monitoring indexes including the Glasgow Coma Scale (GCS), age, sex, temperature, heart rate, respiration rate, blood pressure, or volume of the unilateral-dominant BFC before surgery (Table 1)
Summary
A bilateral frontal contusion (BFC) is a common traumatic brain injury in clinical practice [1]. Because the injury site is close to the cerebral midline, frontal cerebral contusions can cause central herniations that significantly impact patient prognosis [2]. Bilateral frontotemporal craniotomy may effectively evacuate the hematoma and achieve decompression, but the approach has drawbacks such as a longer operative time, intraoperative blood loss, and trauma that may result in complications. Microscope-assisted surgical techniques, such as frontotemporal craniotomy via a small bone window combined with a falx incision, have been shown to greatly reduce brain tissue injury and improve the prognosis of BFC patients [3]. Patients with unilateral-dominant BFCs have traditionally been treated with unilateral frontotemporal craniotomy (UFTC) via a small bone window to evacuate contused brain tissue and intracerebral hematomas. We found that the SKA had the following advantages: less trauma, shorter operative times, faster postoperative recovery, and fewer complications
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
