Aneurysm Surgery, Cerebral Aneurysm Surgery: Dr. Jho's Mini-craniotomy Brain Aneurysm Surgery

Aneurysm Surgery, Cerebral Aneurysm Surgery: Dr. Jho's Mini-craniotomy Brain Aneurysm Surgery

Dr. Jho's "Band-Aid" Eyebrow Incision Skull Base Surgery for Cerebral Aneurysms

Professor & Chair, Department of Neuroendoscopy

Jho Institute for Minimally Invasive Neurosurgery

"Band-Aid" skull base brain surgery for cerebral aneurysms has been developed for minimally invasive cerebral aneurysm surgery. The small surgical skin incision follows the contour of the eyebrow. A tiny skull opening is made for exposure at the skull base where the cerebral aneurysm is located. After a surgical aneurysm clip is successfully placed at the neck of the aneurysm sac, the surgical opening is closed cosmetically. Metallic brain retractors are not used during surgery in order to avoid unwanted brain damage.

Figure 1. A preoperative cerebral arteriogram (A) shows a basilar tip aneurysm. A postoperative arteriogram, after aneurysm clipping via a superolateral orbital craniotomy, confirms successful clipping (B). A patient with a healed superolateral orbital craniotomy incision line (C) (arrows).

Facts About This Surgery

This method is minimally invasive because it utilizes a smaller hole in the bone as well as a smaller incision than conventional methods.

This technique is innovative because it does not require the use of brain retractors, minimizing the risk of brain damage.

The approach does not sacrifice exposure or outcome by being less invasive.

This procedure provides an alternative to the conventional procedures that often utilize extensive bone and skin flaps.

Discussion

Utilizing a small hole in the skull above and to the side of the eyebrow, this minimally invasive skull base procedure provides a direct "shortcut" approach to tumors and aneurysms. Nicknamed "Band-Aid" surgery because only a "Band-Aid" type of small bandage is needed to cover the postoperative incision, this surgery does not sacrifice exposure for the surgeon while providing the many benefits of being less invasive. Cerebral aneurysms can be reached through a two-inch skin incision and a small bone hole called a craniotomy. This technique is referred to as a superolateral craniotomy because the approach is above the eye and slightly to the side. Brain retractors are not used, which reduces the risk of brain injury. Positive feedback has been received concerning the cosmetic healing of the small incision.

Reference

Jho HD: Superolateral orbital approach via a lateral eyebrow incision as a simplified skull base approach. In Rengachary SS, Wilkins RJ (eds), Neurosurgical Operative Color Atlas, Williams and Wilkins (in press)

For referral information or appointment for consultation contact:

Practice Manager: Robin A. Coret

e-mail : Drjho@ahn.org

Tel : (412) 359-6110

Fax : (412) 359-8339

Address : JHO Institute for Minimally Invasive Neurosurgery

Department of Neuroendoscopy

Sixth Floor, South Tower

Allegheny General Hospital

320 East North Avenue

Pittsburgh, PA 15212-4772

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Dr. Jho via e-mail Drjho@ahn.org