Lateral Supraorbital Craniotomy: Neurosurgical Approach for Anterior Cranial Fossa Lesion
Keywords:
Lateral supraorbital craniotomy; anterior cranial fossa; skull-base surgery; gross-total resection; postoperative complications; Karnofsky Performance Status; Glasgow Outcome Scale; radiological outcomes; hospital length of stay.Abstract
Background: The lateral supraorbital (LSO) craniotomy is a limited-exposure frontal–basal approach used for anterior cranial fossa (ACF) lesions. Evidence evaluating effectiveness and safety from Indian tertiary centres remains sparse.
Objective: To evaluate effectiveness and safety of LSO for ACF pathology in a single-centre cohort, reporting radiological, peri-operative, and functional outcomes.
Methods: We conducted a retrospective observational cohort at a tertiary teaching hospital. Consecutive adults (18–75 years) with imaging-confirmed ACF lesions selected for LSO were included. Data were abstracted from operative records, imaging, and clinic follow-up. Outcomes were extent of resection (EOR: gross-total resection [GTR] vs subtotal resection [STR]), predefined complications (e.g., CSF leak, infection, transient deficits), ICU/hospital stay, and functional status (Karnofsky Performance Status [KPS], Glasgow Outcome Scale [GOS]).
Results: The study included 120 patients (mean age 52.4 ± 12.1 years; 56.7% male). Early postoperative imaging showed GTR in 81.7% (98/120) and STR in 18.3% (22/120). Complications were infrequent: CSF leak 4.2% (5/120), infection 2.5% (3/120), transient neurological deficits 7.5% (9/120); revision surgery occurred in 1.7% (2/120). Mean operative time was 145.2 ± 30.6 minutes, and mean hospital stay 5.8 ± 2.3 days. Functional outcomes (KPS, GOS) were captured at discharge and follow-up; values will be reported in structured tables based on the master dataset.
Conclusions: In this single-centre experience, LSO provided effective access to ACF lesions with high rates of gross-total resection, low early complication frequencies, and short hospitalization. Findings support LSO as a practical skull-base option in resource-aware settings when case selection and postoperative imaging are standardized. Prospective multicentre studies with uniform patient-reported outcomes and volumetric measures are warranted.
