{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T02:05:48Z","timestamp":1767665148515,"version":"build-2065373602"},"reference-count":19,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Due to a unique cortical venous drainage pattern without sinus drainage, ethmoidal dural arteriovenous fistula (DAVF) are uncommon cerebral vascular lesions that carry a high risk of brain bleeding and neurologic deficit. Surgical intervention has been found to have a lower complication rate and a more satisfactory obliteration rate than endovascular treatment among the various DAVF treatment options. The supraorbital keyhole subfrontal approach is one of the least invasive and appropriate surgical techniques for addressing the anterior fossa vascular lesion in eDAVFs. We describe two men, ages 60 and 71, who underwent this surgical intervention to treat asymptomatic Cognard type IV eDAVFs. Complete obliteration with a detached fistulous point and skeletonization was accomplished with the aid of intraoperative neuronavigation. Thus, we suggest that a suitable surgical method for the treatment of eDAVFs would be to use a supraorbital keyhole subfrontal approach.<\/jats:p>","DOI":"10.3390\/medicina60071128","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T14:04:35Z","timestamp":1720793075000},"page":"1128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Treatment of Ethmoidal Dural Arteriovenous Fistulae Using Supraorbital Keyhole Subfrontal Approach"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8091-8265","authenticated-orcid":false,"given":"Tsung-Hao","family":"Li","sequence":"first","affiliation":[{"name":"School of Medicine, Chung Shan Medical University, Taichung City 402, Taiwan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1118-7221","authenticated-orcid":false,"given":"Chun-Ting","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Linkou Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan-Yun","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New Taipei Municipal Tu-Cheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City 236, Taiwan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Chang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Linkou Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao-Chieh","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Medicine, Chung Shan Medical University, Taichung City 402, Taiwan, China"},{"name":"Department of Neurosurgery, Chung Shan Medical University Hospital, Taichung City 402, Taiwan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1148\/93.5.1071","article-title":"Involvement of dural arteries in intracranial arteriovenous malformations","volume":"93","author":"Newton","year":"1969","journal-title":"Radiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1148\/rg.246045026","article-title":"Treatment of intracranial dural arteriovenous fistulas: Current strategies based on location and hemodynamics, and alternative techniques of transcatheter embolization","volume":"24","author":"Kiyosue","year":"2004","journal-title":"Radiographics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.wneu.2016.05.052","article-title":"Clinical and Anatomic Insights from a Series of Ethmoidal Dural Arteriovenous Fistulas at Barrow Neurological Institute","volume":"93","author":"Gross","year":"2016","journal-title":"World Neurosurg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1227\/NEU.0b013e318230966f","article-title":"The natural history of cranial dural arteriovenous fistulae with cortical venous reflux\u2014The significance of venous ectasia","volume":"70","author":"Bulters","year":"2012","journal-title":"Neurosurgery"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1161\/STROKEAHA.116.012784","article-title":"Intracranial Dural Arteriovenous Fistulae","volume":"48","author":"Reynolds","year":"2017","journal-title":"Stroke"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.wneu.2019.04.227","article-title":"Treatment of Ethmoidal Dural Arteriovenous Fistulas: A Meta-analysis Comparing Endovascular versus Surgical Treatment","volume":"128","author":"Giannopoulos","year":"2019","journal-title":"World Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"117","DOI":"10.7461\/jcen.2023.E2022.10.006","article-title":"Role of surgery in management of intracranial dural arteriovenous fistulas","volume":"25","author":"Kang","year":"2023","journal-title":"J. Cerebrovasc. Endovasc. Neurosurg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"172","DOI":"10.4103\/2152-7806.146345","article-title":"Transfrontal sinus approach for an anterior cranial fossa, ethmoidal, dural arteriovenous fistula","volume":"5","author":"Magro","year":"2014","journal-title":"Surg. Neurol. Int."},{"key":"ref_9","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"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"158","DOI":"10.3171\/2012.7.GKS12967","article-title":"Role of Gamma Knife surgery in the treatment of intracranial dural arteriovenous fistulas","volume":"117","author":"Hanakita","year":"2012","journal-title":"J. Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1136\/svn-2019-000269","article-title":"Updates in the management of cranial dural arteriovenous fistula","volume":"5","author":"Baharvahdat","year":"2020","journal-title":"Stroke Vasc. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1148\/radiology.194.3.7862961","article-title":"Cerebral dural arteriovenous fistulas: Clinical and angiographic correlation with a revised classification of venous drainage","volume":"194","author":"Cognard","year":"1995","journal-title":"Radiology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.nec.2011.09.003","article-title":"Classification schemes of cranial dural arteriovenous fistulas","volume":"23","author":"Gomez","year":"2012","journal-title":"Neurosurg. Clin. N. 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