{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:40:30Z","timestamp":1790682030121,"version":"4.1.0"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The supraorbital approach through an eyebrow incision offers the opportunity to access a wide variety of lesions of the anterior, middle, and even the posterior fossa. The minimally invasive keyhole craniotomy limits brain exploration and retraction and offers the potential for improved surgical outcomes and reduced approach-related complications. Patient satisfaction, however, has not yet been reported in the literature.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>From January 2002 through December 2011, the lead author (R.R.) used a supraorbital approach through an eyebrow incision for 418 patients with cerebral aneurysms, brain tumors or cystic lesions, and other miscellaneous pathological conditions. For 408 of these patients, a detailed retrospective case note review was conducted to extract data on surgical outcomes and complications, and 375 patients completed a follow-up patient satisfaction questionnaire.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>During the early perioperative period, 8 patients died (overall mortality rate 2.0%). Among patients surveyed, the overall level of satisfaction was high. Patients rated pain from the scar and headache on a scale from 1 to 5 (1 = no pain, 5 = severe pain) as follows: pain was a score of 1 for 289 patients (77.0%), 2 for 46 (12.3%), 3 for 22 (5.9%), 4 for 12 (3.2%), and 5 for 6 (1.6%). Patients also rated cosmetic outcome on a scale from 1 to 5 (1 = very pleasant, 5 = very unpleasant) as follows: outcome was a score of 1 for 315 patients (84.0%), 2 for 33 (8.8%), 3 for 14 (3.7%), 4 for 10 (2.7%), and 5 for 3 (0.8%). Postoperative chewing difficulty was reported for 8 patients (8 [2.1%] temporary, 0 permanent); palsy of the frontal muscle for 21 patients (5.6%; 13 [3.5%] temporary, 8 [2.1%] permanent); frontal hypesthesia for 31 patients (8.3%; 18 [4.8%] temporary, 13 [3.4%] permanent); and hyposmia for 11 patients (2.9%; 3 [0.8%] temporary, 8 [2.1%] permanent).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The supraorbital approach to the anterior, middle, and posterior fossae through an eyebrow incision offers a favorable rate of approach-associated surgical complications and high patient satisfaction with cosmetic outcome.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.4.jns13787","type":"journal-article","created":{"date-parts":[[2014,5,30]],"date-time":"2014-05-30T14:07:04Z","timestamp":1401458824000},"page":"730-734","source":"Crossref","is-referenced-by-count":76,"title":["Patients' cosmetic satisfaction, pain, and functional outcomes after supraorbital craniotomy through an eyebrow incision"],"prefix":"10.3171","volume":"121","author":[{"given":"Robert","family":"Reisch","sequence":"first","affiliation":[{"name":"Centre for Endoscopic and Minimally Invasive Neurosurgery, Klinik Hirslanden, Zurich, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani J.","family":"Marcus","sequence":"additional","affiliation":[{"name":"Centre for Endoscopic and Minimally Invasive Neurosurgery, Klinik Hirslanden, Zurich, Switzerland;"},{"name":"Imperial College Healthcare NHS Trust, London, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hugelshofer","sequence":"additional","affiliation":[{"name":"Centre for Endoscopic and Minimally Invasive Neurosurgery, Klinik Hirslanden, Zurich, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas Olmo","family":"Koechlin","sequence":"additional","affiliation":[{"name":"Centre for Endoscopic and Minimally Invasive Neurosurgery, Klinik Hirslanden, Zurich, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Stadie","sequence":"additional","affiliation":[{"name":"Neurosurgical Department, University Hospital Mainz, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf A.","family":"Kockro","sequence":"additional","affiliation":[{"name":"Centre for Endoscopic and Minimally Invasive Neurosurgery, Klinik Hirslanden, Zurich, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns13787","series-title":"Acta Neurol Scand Suppl","first-page":"522","article-title":"Clinical and experimental brain retraction pressure monitoring","volume":"64","author":"Albin","year":"1977"},{"key":"b2-jns13787","series-title":"Surg Forum","first-page":"499","article-title":"Brain retraction pressure during intracranial procedures","volume":"26","author":"Albin","year":"1975"},{"key":"b3-jns13787","series-title":"Neurosurgery","first-page":"1052","article-title":"A review of brain retraction and recommendations for minimizing intraoperative brain injury","volume":"33","author":"Andrews","year":"1993"},{"key":"b4-jns13787","series-title":"J Neurosurg","doi-asserted-by":"publisher","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"},{"key":"b5-jns13787","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.1227\/00006123-199506000-00009","article-title":"Endoscope-assisted craniotomy: approach to the rostral brain stem","volume":"36","author":"Cohen","year":"1995"},{"key":"b6-jns13787","series-title":"Surg Neurol","doi-asserted-by":"publisher","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"},{"key":"b7-jns13787","series-title":"Neurosurgery","first-page":"145","article-title":"Surgical experience with frontolateral keyhole craniotomy through a superciliary skin incision","volume":"48","author":"Czirj\u00e1k","year":"2001"},{"key":"b8-jns13787","series-title":"Neurosurgery","first-page":"ONS212","article-title":"An anatomical evaluation of the minisupraorbital approach and comparison with standard craniotomies","volume":"59","author":"Figueiredo","year":"2006"},{"key":"b9-jns13787","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1097\/00006123-199802000-00008","article-title":"Endoscope-assisted brain surgery: part 2\u2014analysis of 380 procedures","volume":"42","author":"Fries","year":"1998"},{"key":"b10-jns13787","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1055\/s-2008-1052226","article-title":"Biportal neuroendoscopic microsurgical approaches to the subarachnoid cisterns. A cadaver study","volume":"39","author":"Fries","year":"1996"},{"key":"b11-jns13787","series-title":"Acta Neurochir Suppl","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/3-211-27911-3_4","article-title":"Lateral supraorbital approach as an alternative to the classical pterional approach","volume":"94","author":"Hernesniemi","year":"2005"},{"key":"b12-jns13787","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"270","DOI":"10.3171\/jns.1987.66.2.0270","article-title":"Monitoring retraction pressure on the brain. An experimental and clinical study","volume":"66","author":"Hongo","year":"1987"},{"key":"b13-jns13787","series-title":"Front Biosci","first-page":"3793","article-title":"Surgical brain injury: prevention is better than cure","volume":"13","author":"Jadhav","year":"2008"},{"key":"b14-jns13787","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1227\/NEU.0b013e31821819a0","article-title":"The impact of minimizing brain retraction in aneurysm surgery: evaluation using magnetic resonance imaging","volume":"69","author":"Krayenb\u00fchl","year":"2011"},{"key":"b15-jns13787","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1097\/00006123-199901000-00062","article-title":"Endoscope-assisted supraorbital craniotomy for lesions of the interpeduncular fossa","volume":"44","author":"Menovsky","year":"1999"},{"key":"b16-jns13787","series-title":"Arch Facial Plast Surg","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1001\/archfaci.5.6.488","article-title":"Comparison of absorbable with nonabsorbable sutures in closure of facial skin wounds","volume":"5","author":"Parell","year":"2003"},{"key":"b17-jns13787","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1097\/00006123-199802000-00001","article-title":"Endoscope-assisted brain surgery: part 1\u2014evolution, basic concept, and current technique","volume":"42","author":"Perneczky","year":"1998"},{"key":"b18-jns13787","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1097\/00006123-200207000-00019","article-title":"Trans-supraorbital approach to supratentorial aneurysms","volume":"51","author":"Ramos-Z\u00fa\u00f1iga","year":"2002"},{"issue":"4 Suppl","key":"b19-jns13787","series-title":"Neurosurgery","first-page":"242","article-title":"Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision","volume":"57","author":"Reisch","year":"2005"},{"key":"b20-jns13787","series-title":"Surg Neurol","doi-asserted-by":"publisher","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"},{"key":"b21-jns13787","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1055\/s-0029-1238285","article-title":"The minimally invasive supraorbital subfrontal key-hole approach for surgical treatment of temporomesial lesions of the dominant hemisphere","volume":"52","author":"Reisch","year":"2009"},{"issue":"2 Suppl","key":"b22-jns13787","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"S17.e9","DOI":"10.1016\/j.wneu.2012.02.024","article-title":"The keyhole concept in neurosurgery","volume":"79","author":"Reisch","year":"2013"},{"key":"b23-jns13787","series-title":"Surg Neurol Int","doi-asserted-by":"publisher","first-page":"167","DOI":"10.4103\/2152-7806.90029","article-title":"Slack brain in meningioma surgery through lateral supraorbital approach","volume":"2","author":"Romani","year":"2011"},{"key":"b24-jns13787","series-title":"Neurosurgery","first-page":"347","article-title":"Transorbital keyhole approach to anterior communicating artery aneurysms","volume":"48","author":"Steiger","year":"2001"},{"key":"b25-jns13787","series-title":"Neuroradiology","first-page":"765","article-title":"Technical pitfalls in a porcine brain retraction model. The impact of brain spatula on the retracted brain tissue in a porcine model: a feasibility study and its technical pitfalls","volume":"47","author":"Thiex","year":"2005"},{"key":"b26-jns13787","series-title":"Surg Neurol","doi-asserted-by":"publisher","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"},{"key":"b27-jns13787","series-title":"J Neurosurg","doi-asserted-by":"publisher","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"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/121\/3\/article-p730.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/121\/3\/article-p730.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/121\/3\/article-p730.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T01:39:40Z","timestamp":1658713180000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/121\/3\/article-p730.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2014,9]]},"references-count":27,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2014.4.jns13787","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9]]}}}