{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T01:55:46Z","timestamp":1784339746086,"version":"3.55.0"},"reference-count":11,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The goal of this study was to evaluate the feasibility of a minimally invasive approach to the middle cranial fossa using a novel endaural keyhole.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The charts of all patients who underwent this novel minimally invasive approach to the middle cranial fossa were retrospectively reviewed. In addition, cadaveric dissection was performed to demonstrate the feasibility of the endaural keyhole to the middle cranial fossa.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Six patients (5 female and 1 male; age range 47\u201377 years) who underwent craniotomy for CSF leak (n = 3), intracerebral hematoma evacuation (n = 2), and tumor resection (n = 1) via the endaural subtemporal approach were identified. There were no approach-related complications noted. Representative imaging from cadaveric dissection is provided with a stepwise discussion of the procedure.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The endaural subtemporal keyhole craniotomy provides a novel approach to middle fossa skull base pathology, as well as a minimally invasive approach to intra-axial pathology of the temporal lobe and basal ganglia. Further research is needed to establish the limitations and potential complications of this novel approach.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.2.jns232068","type":"journal-article","created":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T01:38:06Z","timestamp":1715996286000},"page":"1063-1070","source":"Crossref","is-referenced-by-count":3,"title":["The endaural subtemporal keyhole: a novel minimally invasive approach to the middle cranial fossa"],"prefix":"10.3171","volume":"141","author":[{"given":"Adam M.","family":"Olszewski","sequence":"first","affiliation":[{"name":"Divisions of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellina","family":"Hattar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Curry","sequence":"additional","affiliation":[{"name":"Neurotology, House Institute, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Peng","sequence":"additional","affiliation":[{"name":"Neurotology, House Institute, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory P.","family":"Lekovic","sequence":"additional","affiliation":[{"name":"Divisions of Neurosurgery and"},{"name":"Department of Neurosurgery, University of California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2 Suppl","key":"b1","series-title":"World Neurosurg","first-page":"S17.e9","article-title":"The keyhole concept in neurosurgery","volume":"79","author":"Reisch R","year":"2013","unstructured":"Reisch R, Stadie A, Kockro RA, Hopf N. The keyhole concept in neurosurgery. World Neurosurg. 2013;79(2 Suppl):S17.e9\u2013S17.e13."},{"key":"b2","series-title":"Minim Invasive Surg","first-page":"296469","article-title":"The supraorbital keyhole craniotomy through an eyebrow incision: its origins and evolution","volume":"2013","author":"Ormond DR","year":"2013","unstructured":"Ormond DR, Hadjipanayis CG. The supraorbital keyhole craniotomy through an eyebrow incision: its origins and evolution. Minim Invasive Surg. 2013;2013:296469."},{"issue":"6","key":"b3","series-title":"Skull Base","first-page":"371","article-title":"The keyhole retrosigmoid approach to the cerebello-pontine angle: indications, technical modifications, and results","volume":"18","author":"Mostafa BE","year":"2008","unstructured":"Mostafa BE, El Sharnoubi M, Youssef AM. The keyhole retrosigmoid approach to the cerebello-pontine angle: indications, technical modifications, and results. Skull Base. 2008;18(6):371\u2013376."},{"issue":"S 01","key":"b4","series-title":"J Neurol Surg B Skull Base","first-page":"S1","article-title":"Endaural subtemporal approach for middle fossa encephalocele and CSF leak repair","volume":"84","author":"Peng KA","unstructured":"Peng KA, Olszewski A, Bigelow R, Lekovic GP. Endaural subtemporal approach for middle fossa encephalocele and CSF leak repair. J Neurol Surg B Skull Base. 84(S 01):S1\u2013S344."},{"key":"b5","series-title":"World Neurosurg","first-page":"e683","article-title":"Minimally invasive repair of tegmen defects through keyhole middle fossa approach to reduce hospitalization","volume":"133","author":"Wong AK","year":"2020","unstructured":"Wong AK, Shinners M, Wong RH. Minimally invasive repair of tegmen defects through keyhole middle fossa approach to reduce hospitalization. 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J Neurosurg. 2018;128(6):1880\u20131884."},{"issue":"10175","key":"b7","series-title":"Lancet","first-page":"1021","article-title":"Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial","volume":"393","author":"Hanley DF","year":"2019","unstructured":"Hanley DF, Thompson RE, Rosenblum M,  Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial. Lancet. 2019;393(10175):1021\u20131032."},{"issue":"Suppl 1","key":"b8","series-title":"Neurosurgery","first-page":"187","article-title":"305 The INVEST trial: a randomized, controlled trial to investigate the safety and efficacy of image-guided minimally invasive endoscopic surgery with Apollo vs best medical management for supratentorial intracerebral hemorrhage","volume":"63","author":"Fiorella D","year":"2016","unstructured":"Fiorella D, Arthur AS, Mocco JD. 305 The INVEST trial: a randomized, controlled trial to investigate the safety and efficacy of image-guided minimally invasive endoscopic surgery with Apollo vs best medical management for supratentorial intracerebral hemorrhage. Neurosurgery. 2016;63(Suppl 1):187."},{"issue":"11","key":"b9","series-title":"Stroke","first-page":"2749","article-title":"ICES (Intraoperative Stereotactic Computed Tomography-Guided Endoscopic Surgery) for brain hemorrhage: a multicenter randomized controlled trial","volume":"47","author":"Vespa P","year":"2016","unstructured":"Vespa P, Hanley D, Betz J,  ICES (Intraoperative Stereotactic Computed Tomography-Guided Endoscopic Surgery) for brain hemorrhage: a multicenter randomized controlled trial. Stroke. 2016;47(11):2749\u20132755."},{"key":"b10","series-title":"Front Neurol","first-page":"1126958","article-title":"Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH): study protocol for a multi-centered two-arm randomized adaptive trial","volume":"14","author":"Ratcliff JJ","year":"2023","unstructured":"Ratcliff JJ, Hall AJ, Porto E,  Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH): study protocol for a multi-centered two-arm randomized adaptive trial. Front Neurol. 2023;14:1126958."},{"key":"b11","series-title":"Front Neurol","first-page":"884157","article-title":"Minimally invasive surgery for spontaneous intracerebral hematoma. Real-life implementation model and economic estimation","volume":"13","author":"Mosteiro A","year":"2022","unstructured":"Mosteiro A, Amaro S, Torn\u00e9 R,  Minimally invasive surgery for spontaneous intracerebral hematoma. Real-life implementation model and economic estimation. 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