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Lateral supraorbital versus pterional approach for parachiasmal meningiomas: surgical indications and esthetic benefits

 Hun Ho Park  ;  Kyoung Su Sung  ;  Ju Hyung Moon  ;  Eui Hyun Kim  ;  Sun Ho Kim  ;  Kyu-Sung Lee  ;  Chang-Ki Hong  ;  Jong Hee Chang 
 NEUROSURGICAL REVIEW, Vol.43(1) : 313-322, 2020 
Journal Title
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The lateral supraorbital (LSO) approach is a minimally invasive modification of the pterional approach. The authors assess the surgical indications and esthetic benefits of the LSO approach in comparison with the pterional approach for parachiasmal meningiomas. From April 2013 to May 2017, a total of 64 patients underwent surgery for parachiasmal meningiomas. Among them, tumor resection was performed with the LSO approach for 34 patients and pterional approach for 30 patients. A retrospective analysis was done on tumor characteristics, surgical outcome, approach-related morbidity, and esthetic outcome between the two approaches. Gross total resection was achieved in 33 of 34 patients (97.1%) with the LSO approach. There were no differences in tumor size, origin, consistency, internal carotid artery encasement, cranial nerve adhesion, and optic canal invasion between the two approaches. The most common tumor origin was the tuberculum sellae for both the LSO and pterional approaches. For tumors with preoperative visual compromise, immediate visual outcome improved or remained stable in 76% and 80.9% with the LSO and pterional approaches, respectively. Surgery time, surgical bleeding, hospital length of stay, and esthetic outcome were significantly shorter and superior with the LSO approach. There were no differences in surgical morbidity and brain retraction injury between the two approaches. The LSO approach can provide a safe, rapid, and minimally invasive exposure for parachiasmal meningiomas compared with the pterional approach. Surgeons must consider tumor size, origin, and extent in determining the resectability of the tumor rather than the extent of exposure.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sun Ho(김선호) ORCID logo https://orcid.org/0000-0003-0970-3848
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Moon, Ju Hyung(문주형)
Park, Hun Ho(박현호) ORCID logo https://orcid.org/0000-0002-2526-9693
Lee, Kyu Sung(이규성)
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Hong, Chang Ki(홍창기) ORCID logo https://orcid.org/0000-0002-2761-0373
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