Comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting

The challenges encountered in performing minimally invasive approaches, such as supraorbital minicraniotomy (SOMC), in services without adequate equipment are rarely reported in the literature. This study analyzes the viability of SOMC in the treatment of cerebral aneurysms, using exactly the same r...

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Bibliographic Details
Published in:	Scientific reports Vol. 11; no. 1; p. 5555
Main Authors:	Fonseca, Ricardo Brandão, Correia, Alyne Oliveira, Vieira, Raysa Siqueira, dos Santos, José Erivaldo Fonseca, Alves-Neto, Heverty Rocha, da Silva Vieira, Anajara Ferraz, Belém, Diego Ramon Ferreira, Tobias-Machado, Marcos, Vidal, Claudio Henrique Fernandes, Waisberg, Jaques
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 10-03-2021 Nature Publishing Group Nature Portfolio
Subjects:	692/617 692/617/375/1370 Aneurysm Aneurysms Cerebral blood flow Comparative studies Humanities and Social Sciences multidisciplinary Neurosurgery Patients Science Science (multidisciplinary) Surgery
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Summary:	The challenges encountered in performing minimally invasive approaches, such as supraorbital minicraniotomy (SOMC), in services without adequate equipment are rarely reported in the literature. This study analyzes the viability of SOMC in the treatment of cerebral aneurysms, using exactly the same resources as pterional craniotomy (PC). The results of these two techniques are compared. 35 patients underwent SOMC, compared to 50 patients underwent CP (100 aneurysms in total), using the same microsurgical instruments. The following variables were compared: operative time, angiographic cure, length of intensive care unit stay during the post-operative period, surgical complications, length of hospital stay after surgery until hospital discharge, intraoperative aneurysm rupture, aesthetic satisfaction with the scar, and neurological status at discharge. SOMC had a significantly shorter operative time in relation to PC (213.9 ± 11.09 min and 268.6 ± 15.44 min, respectively) (p = 0.0081).With respect to the cosmetic parameters assessed by the Visual Analog Scale, the average for SOMC was 94.12 ± 1.92 points, and the average for PC was 83.57 ± 4.75 points (p = 0.036). SOMC was as effective as PC in relation to successful aneurysm clipping (p = 0.77). The SOMC technique did not show advantages over PC in any other variable. Even in a general neurosurgery service lacking a specific structure for minimally invasive surgeries, SOMC was feasible and effective for treating intracranial aneurysms, using the same set of microsurgical instruments used for PC, obtaining better results in operating time and cosmetic satisfaction.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-021-85115-7