The endoscopic supraorbital approach to tumors of the middle cranial base

Abstract

Background Access to tumors of the middle cranial base has traditionally required wide surgical exposures via open craniotomies. These open techniques often require the use of potentially disfiguring skin incisions and are often associated with a significant degree of brain retraction and potential morbidity. We report our experience with the use of a minimally invasive supraorbital endoscopic approach through the eyebrow for excision of middle cranial base tumors in 2 cases. Methods We describe 2 patients with large-sized middle cranial fossa tumors (a medial sphenoid wing meningioma measuring 6 × 4 cm and a recurrent right cavernous sinus meningioma measuring 4 × 3.5 cm) that were entirely removed via a fully endoscopic supraorbital approach using a 1.5-cm keyhole craniotomy. Conclusion These cases demonstrate how the application of endoscopic techniques to surgery of the middle cranial base can eliminate the need for traditional open techniques without compromising surgical success.