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Lateral supraorbital approach for Craniopharyngioma

LSO approach has a similar surgical effect to the standard pterional approach, but it can significantly shorten the operation time, and reduce surgical trauma and the incidence of complications. Therefore, LSO provides another alternative to the surgical approach for microsurgical removal of craniopharyngioma 1).

The resection of tumors at the sellar region via the lateral supraorbital approach is efficient, simple, and minimally invasive, which can make the removal of the tumors reliably and safely. It is worthy to be popularized clinically 2).

Although the endoscopic transnasal approach has developed in leaps and bounds in the last decade, other transcranial approaches maintain their value. The supraorbital endoscopic approach is a minimally invasive approach and seems to be optimal for those lesions wider than 2 cm in the lateral extension and for all the paramedian lesions. 3).

7: Nagata Y, Watanabe T, Nagatani T, Takeuchi K, Chu J, Wakabayashi T. Fully endoscopic combined transsphenoidal and supraorbital keyhole approach for parasellar lesions. J Neurosurg. 2018 Mar;128(3):685-694. doi: 10.3171/2016.11.JNS161833. Epub 2017 Apr 28. PMID: 28452613.

8: Wilson DA, Duong H, Teo C, Kelly DF. The supraorbital endoscopic approach for tumors. World Neurosurg. 2014 Dec;82(6 Suppl):S72-80. doi: 10.1016/j.wneu.2014.07.029. PMID: 25496639.

9: Yin Y, Chen G, Wang Z. [Clinical evaluations of lateral supraorbital microsurgical approach for sellar tumors]. Zhonghua Yi Xue Za Zhi. 2014 Jul 1;94(25):1956-9. Chinese. PMID: 25253009.

10: Chen G, Wang Z, Zhou D. Lateral supraorbital approach applied to sellar tumors in 23 consecutive patients: the Suzhou experience from China. World J Surg Oncol. 2013 Feb 21;11:41. doi: 10.1186/1477-7819-11-41. PMID: 23432938; PMCID: PMC3631129.

11: Wilson DA, Duong H, Teo C, Kelly DF. The supraorbital endoscopic approach for tumors. World Neurosurg. 2014 Jul-Aug;82(1-2):e243-56. doi: 10.1016/j.wneu.2013.02.002. Epub 2013 Feb 5. PMID: 23395805.

12: McLaughlin N, Ditzel Filho LF, Prevedello DM, Kelly DF, Carrau RL, Kassam AB. Side-cutting aspiration device for endoscopic and microscopic tumor removal. J Neurol Surg B Skull Base. 2012 Feb;73(1):11-20. doi: 10.1055/s-0032-1304834. PMID: 23372990; PMCID: PMC3424025.

13: Fatemi N, Dusick JR, de Paiva Neto MA, Malkasian D, Kelly DF. Endonasal versus supraorbital keyhole removal of craniopharyngiomas and tuberculum sellae meningiomas. Neurosurgery. 2009 May;64(5 Suppl 2):269-84; discussion 284-6. doi: 10.1227/01.NEU.0000327857.22221.53. PMID: 19287324.

14: Andaluz N, Romano A, Reddy LV, Zuccarello M. Eyelid approach to the anterior cranial base. J Neurosurg. 2008 Aug;109(2):341-6. doi: 10.3171/JNS/2008/109/8/0341. PMID: 18671651.

15: Lan Q, Dong J, Huang Q. Minimally invasive keyhole approaches for removal of tumors of the third ventricle. Chin Med J (Engl). 2006 Sep 5;119(17):1444-50. PMID: 16989745.

16: Van Effenterre R, Van Effenterre G, Cabanis EA, Iba Zizen MT. Tumeurs supra- sellaires chez les sujets agés de plus de 70 ans. Intérêt d'une crâniectomie fronto-temporale limitée. Résultats visuels. A propos de 5 cas [Suprasellar tumors in patients over 70 years of age. Value of limited frontotemporal craniotomy. Visual results. Apropos of 5 cases]. Neurochirurgie. 1991;37(5):330-7. French. PMID: 1758566.

Zhao C, Chen Z, Xu N, Xue T, Wu X, You W, Zhu Y, Wang Z. Comparative analysis on microsurgical removal of craniopharyngioma via lateral supraorbital approach and standard pterional approach. Chin Neurosurg J. 2018 Aug 1;4:16. doi: 10.1186/s41016-018-0126-7. PMID: 32922877; PMCID: PMC7398233.
Lu XY, Fu XJ, Zeng HH, Yao Y, Wang L. [Microsurgical resection of sellar tumors via lateral supraorbital approach: clinical analysis of 20 cases]. Zhonghua Yi Xue Za Zhi. 2018 Jun 19;98(23):1859-1862. Chinese. doi: 10.3760/cma.j.issn.0376-2491.2018.23.011. PMID: 29925170.
Peraio S, Chumas P, Nix P, Phillips N, Tyagi A. From above or from below? That is the question. Comparison of the supraorbital approach with the endonasal approach. A cadaveric study. Br J Neurosurg. 2018 Oct;32(5):548-552. doi: 10.1080/02688697.2018.1480748. Epub 2018 Jun 6. PMID: 29873260.
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