{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:52:11Z","timestamp":1786125131224,"version":"build-2736575974"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2019,8,15]],"date-time":"2019-08-15T00:00:00Z","timestamp":1565827200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The classic pterional, pretemporal, and orbitozygomatic approaches achieve large areas of exposure with easy maneuverability. In select cases (eg, some anterior circulation aneurysms), the minimally invasive fronto-orbital craniotomy can yield adequate exposure that must be balanced with its risk of frontalis injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To detail a 10-yr experience using the transpalpebral approach, characterized by an incision whose camouflage is the natural eyelid crease, notably the effectiveness and outcomes of this exposure for anterior circulation aneurysms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In this retrospective review, 82 patients with 88 aneurysms underwent a supraorbital frontal minicraniotomy via the eyelid incision performed by a single neurosurgeon and closure by an oculoplastic surgeon (2007-2016). Incision of the orbiculi oculi developed a plane between the muscle and orbital septum superiorly. Outcomes recorded included aneurysm occlusion or residual, treatment modality (clipping\/wrapping), postoperative hemorrhage or stroke, postoperative wound healing, and overall cosmesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 85 (97%) aneurysms treated by clipping, postoperative and follow-up imaging showed complete obliteration in 81 (95%) aneurysms and residuals in 4 (5%). Cosmetic outcomes for the eyelid incision were excellent: 81 (99%) patients noted excellent wound healing at follow-up and no scarring; 1 patient developed significant temporalis wasting and upper eyelid scarring after posterior communicating artery aneurysm clipping. Overall, 13 minor and 8 major complications affected 19 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Our findings confirm the versatility of the eyelid supraorbital frontal minicraniotomy for common anterior circulation aneurysms. This large series found that postoperative complication risks were similar to traditional techniques and cosmetic results were excellent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opz217","type":"journal-article","created":{"date-parts":[[2019,8,16]],"date-time":"2019-08-16T12:13:08Z","timestamp":1565957588000},"page":"309-315","source":"Crossref","is-referenced-by-count":13,"title":["Transpalpebral Approach \u201cEyelid Incision\u201d for Surgical Treatment of Intracerebral Aneurysms: Lessons Learned During a 10-Year Experience"],"prefix":"10.1227","volume":"18","author":[{"given":"Gordon","family":"Mao","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Allegheny General Hospital, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gigliotti","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Aziz","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny General Hospital, Pittsburgh, Pennsylvania"},{"name":"Drexel University School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,3]]},"reference":[{"issue":"4","key":"bib1-20231016","doi-asserted-by":"crossref","first-page":"E20","DOI":"10.3171\/2014.7.FOCUS14203","article-title":"Endoscopic supraorbital eyebrow approach for the surgical treatment of extraaxialand intraaxial tumors","volume":"37","author":"Gazzeri","year":"2014","journal-title":"Neurosurg Focus"},{"issue":"5","key":"bib2-20231016","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1055\/s-2005-915599","article-title":"The keyhole concept in aneurysm surgery - a comparative study: keyhole versus standard craniotomy","volume":"48","author":"Paladino","year":"2005","journal-title":"Minim Invasive Neurosurg"},{"issue":"2 suppl operative","key":"bib3-20231016","first-page":"ons195","article-title":"Minimally invasive transpalpebral \u201ceyelid\u201d approach to the anterior cranial base","volume":"69","author":"Abdel Aziz","year":"2011","journal-title":"Neurosurgery"},{"issue":"1","key":"bib4-20231016","doi-asserted-by":"crossref","first-page":"102","DOI":"10.3171\/jns.1971.34.1.0102","article-title":"Limited exposure in cerebral surgery: technical note","volume":"34","author":"Wilson","year":"1971","journal-title":"J Neurosurg"},{"issue":"6","key":"bib5-20231016","first-page":"185","article-title":"The small frontolateral approach for the microsurgical treatment of intracranial aneurysms","volume":"21","author":"Brock","year":"1978","journal-title":"Neurochirurgia (Stuttg)"},{"issue":"1","key":"bib6-20231016","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1055\/s-0030-1247504","article-title":"The supraorbital craniotomy for access to the skull base and intraaxial lesions: a technique in evolution","volume":"53","author":"Raza","year":"2010","journal-title":"Minim Invasive Neurosurg"},{"issue":"5","key":"bib7-20231016","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":"Van Lindert","year":"1998","journal-title":"Surg Neurol"},{"issue":"5","key":"bib8-20231016","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/S0090-3019(02)00698-5","article-title":"Bilateral supraorbital keyhole approach for multiple aneurysms via superciliary skin incisions","volume":"57","author":"Czirj\u00e1k","year":"2002","journal-title":"Surg Neurol"},{"issue":"1","key":"bib9-20231016","first-page":"145","article-title":"Surgical experience with frontolateral keyhole craniotomy through a superciliary skin incision","volume":"48","author":"Czirj\u00e1k","year":"2001","journal-title":"Neurosurgery"},{"issue":"4","key":"bib10-20231016","doi-asserted-by":"crossref","first-page":"714","DOI":"10.3171\/jns.2001.95.4.0714","article-title":"Eyebrow incision for combined orbital osteotomy and supraorbital minicraniotomy: application to aneurysms of the anterior circulation","volume":"95","author":"Dare","year":"2001","journal-title":"J Neurosurg"},{"issue":"1 suppl 1","key":"bib11-20231016","first-page":"ONSE157","article-title":"Eyebrow surgery: The supraciliary craniotomy: technical note","volume":"59","author":"Jallo","year":"2006","journal-title":"Neurosurgery"},{"issue":"1","key":"bib12-20231016","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.surneu.2004.02.030","article-title":"Supraorbital eyebrow minicraniotomy for anterior circulation aneurysms","volume":"63","author":"Mitchell","year":"2005","journal-title":"Surg Neurol"},{"issue":"3","key":"bib13-20231016","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S0090-3019(02)01037-6","article-title":"Surgical technique of the supraorbital key-hole craniotomy","volume":"59","author":"Reisch","year":"2003","journal-title":"Surg Neurol"},{"issue":"4 suppl","key":"bib14-20231016","first-page":"242","article-title":"Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision","volume":"57","author":"Reisch","year":"2005","journal-title":"Neurosurgery"},{"issue":"2","key":"bib15-20231016","first-page":"91","article-title":"Advantages and disadvantages of the supraorbital keyhole approach to intracranial aneurysms","volume":"45","author":"Velimir","year":"2006","journal-title":"Acta Clin Croatica"},{"issue":"5","key":"bib16-20231016","doi-asserted-by":"crossref","first-page":"975","DOI":"10.3171\/2009.10.JNS09435","article-title":"Image-guided anatomical and morphometric study of supraorbital and transorbital minicraniotomies to the sellar and perisellar regions: comparison with standard techniques. Laboratory investigation","volume":"113","author":"Beretta","year":"2010","journal-title":"J Neurosurg"},{"issue":"3","key":"bib17-20231016","doi-asserted-by":"crossref","first-page":"730","DOI":"10.3171\/2014.4.JNS13787","article-title":"Patients' cosmetic satisfaction, pain, and functional outcomes after supraorbital craniotomy through an eyebrow incision","volume":"121","author":"Reisch","year":"2014","journal-title":"J Neurosurg"},{"key":"bib18-20231016","doi-asserted-by":"crossref","DOI":"10.1016\/j.wneu.2018.02.016","article-title":"Minimally invasive alternative approaches to pterional craniotomy: a systematic review of the literature","author":"Rychen","year":"2018","journal-title":"World Neurosurg"},{"key":"bib19-20231016","article-title":"A review of the literature on the transciliary supraorbital keyhole approach","author":"Zumofen","year":"2017","journal-title":"J Neurosurg"},{"issue":"4","key":"bib20-20231016","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1093\/ons\/opx021","article-title":"Minimally invasive transpalpebral \u201ceyelid\u201d approach to unruptured middle cerebral artery aneurysms","volume":"13","author":"Mandel","year":"2017","journal-title":"Oper Neurosurg"},{"issue":"3","key":"bib21-20231016","doi-asserted-by":"crossref","first-page":"A088","DOI":"10.1055\/s-2009-1242366","article-title":"The extended transorbital upper lid crease craniotomy: a less invasive alternative to the supraorbital craniotomy","volume":"19","author":"Moe","year":"2009","journal-title":"Skull Base"},{"issue":"4","key":"bib22-20231016","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1055\/s-2000-9337","article-title":"Accessing the orbital roof via an eyelid incision: the transpalpebral approach","volume":"10","author":"Ohjimi","year":"2000","journal-title":"Skull Base"},{"issue":"4","key":"bib23-20231016","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1055\/s-0030-1249247","article-title":"Transpalpebral orbitofrontal craniotomy: a minimally invasive approach to anterior cranial vault lesions","volume":"20","author":"Owusu Boahene","year":"2010","journal-title":"Skull Base"},{"issue":"1 suppl operative","key":"bib24-20231016","first-page":"45","article-title":"The keyhole concept in aneurysm surgery: results of the past 20 years","volume":"68","author":"Fischer","year":"2011","journal-title":"Neurosurgery"},{"issue":"6","key":"bib25-20231016","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1097\/00006123-200006000-00003","article-title":"What percentage of surgically clipped intracranial aneurysms have residual necks?","volume":"46","author":"Thornton","year":"2000","journal-title":"Neurosurgery"},{"issue":"4","key":"bib26-20231016","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1055\/s-2008-1052042","article-title":"Eyebrow keyhole approach in vascular neurosurgery","volume":"41","author":"Paladino","year":"1998","journal-title":"Minim Invasive Neurosurg"},{"issue":"5","key":"bib27-20231016","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1097\/SCS.0b013e3182a2d635","article-title":"Superior eyelid crease approach for transobital neuroendoscopic surgery of the anterior cranial fossa","volume":"24","author":"Koppe","year":"2013","journal-title":"J Craniofac Surg"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/advance-article-pdf\/doi\/10.1093\/ons\/opz217\/29164006\/opz217.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opz217","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:50:41Z","timestamp":1786121441000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opz217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,14]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opz217","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,14]]}}}