{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:08Z","timestamp":1787025728641,"version":"build-2736575974"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,3]]},"abstract":"\n Object<\/jats:title>\n In 2003 the authors introduced a minimally invasive transorbital keyhole approach. Because this approach requires removal of the orbital rim and orbital roof, there have been concerns regarding perioperative morbidity, long-term morbidity, and cosmetic results. The authors evaluated approach-related morbidity and cosmetic results in their patients to determine the rate of complications and compared this to published reports of similar approaches.<\/jats:p>\n <\/jats:sec>\n \n Material<\/jats:title>\n Seventy-one patients (41 female, 30 male) underwent operations using this approach between 2004 and 2008. Immediate approach-related morbidity was recorded after the operation. Late morbidity was determined after 7 months by an independent examiner while cosmetic results were self-rated by the patient using a questionnaire.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Fifty-one (72%) of 71 patients had no postoperative complications and 12 (16.9%) had minor complications, the most common of which was subgaleal CSF collection (7.0%). Other minor complications included facial nerve palsy (2.8%), hyposphagma (2.8%), periorbital swelling due to periorbital hematoma (2.8%), and subdural hematoma (1.4%). Major complications requiring surgical revision occurred in 4 patients (5.6%); these were CSF fistulas in 2 patients, pneumocephalus in 1 patient, and a hematoma in 1 patient. Forty-nine (90.7%) of all 54 examined patients rated the cosmetic results as very good or good. Major long-term morbidity was hyposmia or anosmia (14 patients) followed by hypoesthesia around the scar (9 patients).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The transorbital keyhole approach is a feasible approach with a low-risk profile for postoperative or long-term morbidity and excellent cosmetic outcome.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2010.9.jns1095","type":"journal-article","created":{"date-parts":[[2010,10,29]],"date-time":"2010-10-29T07:48:51Z","timestamp":1288338531000},"page":"852-856","source":"Crossref","is-referenced-by-count":29,"title":["The transorbital keyhole approach: early and long-term outcome analysis of approach-related morbidity and cosmetic results"],"prefix":"10.3171","volume":"114","author":[{"given":"Kerim","family":"Beseoglu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e4tsklinik D\u00fcsseldorf, Heinrich-Heine-Universit\u00e4t, D\u00fcsseldorf; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Lodes","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e4tsklinik D\u00fcsseldorf, Heinrich-Heine-Universit\u00e4t, D\u00fcsseldorf; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Stummer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Jakob","family":"Steiger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e4tsklinik D\u00fcsseldorf, Heinrich-Heine-Universit\u00e4t, D\u00fcsseldorf; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"H\u00e4nggi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e4tsklinik D\u00fcsseldorf, Heinrich-Heine-Universit\u00e4t, D\u00fcsseldorf; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns1095","series-title":"Emerg Radiol","first-page":"441","article-title":"Tension pneumocephalus following pterional craniotomy for treatment of intracavernous internal carotid artery aneurysm","volume":"15","author":"Alibai","year":"2008"},{"key":"b2-jns1095","series-title":"Neurosurgery","first-page":"1140","article-title":"Anatomic and clinical study of the orbitopterional approach to anterior communicating artery aneurysms","volume":"52","author":"Andaluz","year":"2003"},{"key":"b3-jns1095","series-title":"Skull Base","first-page":"241","article-title":"The one-piece orbitopterional approach","volume":"13","author":"Andaluz","year":"2003"},{"key":"b4-jns1095","series-title":"Minim Invasive Neurosurg","first-page":"71","article-title":"Postoperative anosmia after anterior communicating artery aneurysms surgery by the pterional approach","volume":"39","author":"Aydin","year":"1996"},{"key":"b5-jns1095","series-title":"Surg Neurol","first-page":"524","article-title":"Reconstruction of the temporalis muscle for pterional and cranio-orbital craniotomies","volume":"52","author":"Bowles","year":"1999"},{"key":"b6-jns1095","series-title":"Minim Invasive Neurosurg","first-page":"257","article-title":"A pterion keyhole approach for the treatment of anterior circulation aneurysms","volume":"49","author":"Cheng","year":"2006"},{"key":"b7-jns1095","series-title":"J Neurosurg","first-page":"877","article-title":"Subfascial and submuscular methods of temporal muscle dissection and their relationship to the frontal branch of the facial nerve. 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