{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:23:02Z","timestamp":1787775782125,"version":"build-2784847793"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The classical eyebrow supraorbital keyhole craniotomy has limited working volume due to the thick incurving of the frontal bone necessitating generous drilling of the frontal base. However, the basal variant with sectioning of the orbital rim results in increased periorbital edema.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We describe a novel orbital rim sparing single-piece fronto-orbital keyhole approach, probably the first such report with a comparative review of relevant literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Following eyebrow incision, bidirectional drilling with a ball tip behind the fronto-zygomatic suture exposes the periorbita and frontal dura, with orbital roof in-between. The craniotomy is fashioned with an angled fronto-orbital cut parallel to and sparing the orbital rim with dura-guard over the periorbita, a frontal cut over the dura, and an optional cut along the lateral orbital roof from within the burr hole. A comparative review of this technique with traditional methods is also carried out.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Compared to the classical supraorbital keyhole, this minimally invasive approach yields a wider basal exposure with greater working volume for intracranial and orbital lesions. Compared to the basal variant of keyhole fronto-orbital approach, this technique results in the least disturbance to periorbita's attachment with the orbital margin, maintenance of orbital contour, better cosmesis with use of simple tools and self-fitting flap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The orbital rim sparing single-piece fronto-orbital keyhole craniotomy is an easy and novel minimally invasive approach with greater working volume without the disadvantages of sectioning the orbital rim.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.314520","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T01:30:50Z","timestamp":1619400650000},"page":"441-445","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Orbital Rim Sparing Single-piece Fronto-orbital Keyhole Craniotomy Through Eyebrow Incision"],"prefix":"10.4103","volume":"69","author":[{"given":"Sivashanmugam","family":"Dhandapani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lomesh S","family":"Wankhede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-43-20240907","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1016\/j.surneu.2006.06.039","article-title":"Microsurgical experience with keyhole operations on intracranial aneurysms","volume":"66","author":"Lan","year":"2006","journal-title":"Surg Neurol"},{"key":"R3-43-20240907","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.wneu.2017.02.025","article-title":"Keyhole approach for clipping intracranial aneurysm: Comparison of supraorbital and pterional keyhole approach","volume":"102","author":"Lan","year":"2017","journal-title":"World Neurosurgery"},{"key":"R4-43-20240907","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"},{"key":"R5-43-20240907","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/j.wneu.2016.10.110","article-title":"A review of the literature on the transciliary supraorbital keyhole approach","volume":"98","author":"Zumofen","year":"2017","journal-title":"World Neurosurg"},{"key":"R7-43-20240907","doi-asserted-by":"crossref","first-page":"103","DOI":"10.3340\/jkns.2009.46.2.103","article-title":"Microsurgical experience with supraorbital keyhole operations on anterior circulation aneurysms","volume":"46","author":"Park","year":"2009","journal-title":"J Korean Neurosurg Soc"},{"key":"R8-43-20240907","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.wneu.2017.02.011","article-title":"Quantification of working volumes, exposure, and target-specific maneuverability of the pterional craniotomy and its minimally invasive variants","volume":"101","author":"Jagersberg","year":"2017","journal-title":"World Neurosurg"},{"key":"R9-43-20240907","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"},{"key":"R10-43-20240907","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"},{"key":"R11-43-20240907","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1055\/s-2008-1053424","article-title":"Orbital roof craniotomy via an eyebrow incision: A simplified anterior skull base approach","volume":"40","author":"Jho","year":"1997","journal-title":"Minim Invasive Neurosurg"},{"key":"R12-43-20240907","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1007\/s00701-013-1947-y","article-title":"Quantifying surgical access in eyebrow craniotomy with and without orbital bar removal: Cadaver and surgical phantom studies","volume":"156","author":"Zador","year":"2014","journal-title":"Acta Neurochir (Wien"},{"key":"R13-43-20240907","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. 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