{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:42:30Z","timestamp":1787499750897,"version":"build-2736575974"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The supraorbital keyhole approach (SOKHA) has been a less invasive alternative for anterior and middle skull base lesions. We aimed to review our data and understand the advantages and limitations of the approach.<\/jats:p>\n                  <jats:p>We analyzed our data and reviewed 89 consecutive cases who underwent the SOKHA. We included the clinico-radiological parameters, pathology, use of endoscope, complications, etc. for analysis.<\/jats:p>\n                  <jats:p>A total of 47 patients were of aneurysm with a total of 48 aneurysms (39 were ruptured and 9 were unruptured) and Acomm artery aneurysm was the most common site. Meningiomas were the second most common pathology encountered (n\u2009=\u200929). Tuberculum sella meningioma being the most common type of meningiomas operated through this approach. Gross total resection was done in all except two cases in which a small part of the tumor was left behind as the tumor was adhered to blood vessels. Among the remaining cases, craniopharyngiomas (n\u2009=\u20097), optic pathway gliomas (n\u2009=\u20092), hypothalamic hamartomas (n\u2009=\u20092), dermoid (n\u2009=\u20091), and arteriovenous malformation (n\u2009=\u20091) were the other pathologies operated upon. Eight patients had opening of the frontal sinus. Four patients had wound bulge and one patient had cerebrospinal fluid (CSF) rhinorrhea. All these cases were managed conservatively.<\/jats:p>\n                  <jats:p>SOKHA is an excellent approach for anterior cranial fossa lesions especially with properly chosen cases. Incidence of CSF leak in our study is 1.1% and majority can be managed by placement of lumbar drain. Intraoperative obliteration of the frontal sinus can reduce the risk of postoperative CSF leak. A large frontal sinus needs not be a contraindication for SOKHA.<\/jats:p>","DOI":"10.1055\/a-2297-3768","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T18:42:27Z","timestamp":1711996947000},"page":"160-164","source":"Crossref","is-referenced-by-count":1,"title":["Supraorbital Keyhole Approach: Opening of the Frontal Sinus and Cerebrospinal Fluid Rhinorrhea"],"prefix":"10.1055","volume":"86","author":[{"given":"Anant","family":"Mehrotra","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5863-0297","authenticated-orcid":false,"given":"Kuntal Kanti","family":"Das","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamlesh","family":"Rangari","sequence":"additional","affiliation":[{"name":"Neurosurgery, Trauma Care Centre and GMCH, Nagpur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumen","family":"Kanjilal","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Tataskar","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawan Kumar","family":"Verma","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamlesh S.","family":"Bhaisora","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awadhesh","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Kumar","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/00006123-198210000-00016","article-title":"The supraorbital approach: technical note","volume":"11","author":"J A Jane","year":"1982","journal-title":"Neurosurgery"},{"issue":"09","key":"ref2","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1288\/00005537-198409000-00001","article-title":"Supraorbital rim approach to the anterior skull base","volume":"94","author":"M J Kaplan","year":"1984","journal-title":"Laryngoscope"},{"key":"ref3","first-page":"271582","article-title":"Cigarette smoke and inflammation: role in cerebral aneurysm formation and rupture","author":"N Chalouhi","year":"2012","journal-title":"Mediators Inflamm"},{"key":"ref4","first-page":"324","article-title":"Transciliary orbitofrontozygomatic approach to lesions of the anterior cranial fossa","volume":"64","author":"W L Warren","year":"2009","journal-title":"Neurosurgery"},{"issue":"04","key":"ref5","first-page":"242","article-title":"Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision","volume":"57","author":"R Reisch","year":"2005","journal-title":"Neurosurgery"},{"issue":"01","key":"ref6","first-page":"145","article-title":"Surgical experience with frontolateral keyhole craniotomy through a superciliary skin incision","volume":"48","author":"S Czirj\u00e1k","year":"2001","journal-title":"Neurosurgery"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/S0090-3019(96)00539-3","article-title":"The supraorbital keyhole approach to supratentorial aneurysms: concept and technique","volume":"49","author":"E van Lindert","year":"1998","journal-title":"Surg Neurol"},{"issue":"02","key":"ref8","first-page":"112","article-title":"Piezosurgery as a further technical adjunct in minimally invasive supraorbital keyhole approach and lateral orbitotomy","volume":"76","author":"M Iacoangeli","year":"2015","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"e667","DOI":"10.1016\/j.wneu.2018.12.188","article-title":"Supraorbital keyhole approach: lessons learned from 106 operative cases","volume":"124","author":"U Eroglu","year":"2019","journal-title":"World Neurosurg"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"850","DOI":"10.3171\/2010.6.JNS10878","article-title":"The supraorbital \u201ckeyhole\u201d approach","volume":"114","author":"R C Heros","year":"2011","journal-title":"J Neurosurg"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1590\/S0004-282X2010000300018","article-title":"Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas","volume":"68","author":"M A Paiva-Neto","year":"2010","journal-title":"Arq Neuropsiquiatr"},{"key":"ref12","first-page":"296469","article-title":"The supraorbital keyhole craniotomy through an eyebrow incision: its origins and evolution","volume":"2013","author":"D R Ormond","year":"2013","journal-title":"Minim Invasive Surg"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1055\/s-0034-1389368","article-title":"Supraorbital keyhole approach to the skull base: evaluation of complications related to CSF fistulas and opened frontal sinus","volume":"76","author":"F Thaher","year":"2015","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1227\/01.NEU.0000346266.69493.88","article-title":"Lateral supraorbital approach applied to olfactory groove meningiomas: experience with 66 consecutive patients","volume":"65","author":"R Romani","year":"2009","journal-title":"Neurosurgery"},{"key":"ref15","first-page":"45","article-title":"The keyhole concept in aneurysm surgery: results of the past 20 years","volume":"68","author":"G Fischer","year":"2011","journal-title":"Neurosurgery"}],"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2297-3768.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T18:30:21Z","timestamp":1742927421000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2297-3768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,1]]},"references-count":15,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,3,17]]},"published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2297-3768","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"value":"2193-6331","type":"print"},{"value":"2193-634X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4,1]]},"published":{"date-parts":[[2024,4,1]]}}}