Our Summary

This research paper reviews previous studies on “keyhole” brain surgeries - minimally invasive procedures that use a small hole to access the brain. Three types of these surgeries are considered: minipterional, supraorbital via an eyebrow incision, and supraorbital via an eyelid incision. The goal is to identify and understand the types and frequency of complications that can occur with each approach.

From the analysis of 105 articles covering 5837 surgeries, the researchers found that each approach has its own set of potential issues. For the minipterional type, patients often reported pain while chewing (7.5% of cases). For the eyebrow incision method, temporary facial nerve paralysis and reduced sensitivity above the eye were common, happening in 6.5% and 3.6% of surgeries respectively.

For the eyelid incision method, swelling around the eyes and temporary weakness in eye movement were common, occurring in 36.8% and 17.4% of surgeries respectively. These two complications were often related to removal of part of the bone around the eye, which is necessary for this type of surgery but not for the eyebrow incision method.

In conclusion, the researchers highlight the importance of understanding these potential complications when deciding on the best surgical approach for each individual patient.

FAQs

  1. What are the three types of “keyhole” brain surgeries discussed in this research paper?
  2. What are the common complications associated with each type of “keyhole” brain surgery?
  3. How does understanding the potential complications of each surgical approach assist in deciding the best method for individual patients?

Doctor’s Tip

One helpful tip a doctor might give a patient about craniotomy is to discuss the potential complications and side effects associated with different surgical approaches, such as “keyhole” brain surgeries. It is important for patients to be informed about the possible risks and benefits of each method in order to make an informed decision about their treatment plan.

Suitable For

Craniotomy is typically recommended for patients with various brain conditions such as brain tumors, aneurysms, arteriovenous malformations, traumatic brain injuries, and epilepsy. The decision to undergo a craniotomy is made based on factors such as the location and size of the brain lesion, the patient’s overall health, and the potential benefits and risks of the surgery. Patients who are young and otherwise healthy are generally good candidates for craniotomy, as they are more likely to recover well from the procedure. Older patients or those with significant medical conditions may still be considered for craniotomy, but the risks and potential complications of the surgery must be carefully weighed against the potential benefits.

Timeline

  • Before the craniotomy:
  1. Patient undergoes various tests and evaluations to determine the need for surgery, such as MRI or CT scans.
  2. Patient meets with their neurosurgeon to discuss the procedure, potential risks, and benefits.
  3. Patient may need to stop certain medications or adjust their diet in preparation for surgery.
  4. Patient may need to stay in the hospital the night before the procedure for monitoring.
  • During the craniotomy:
  1. Patient is placed under general anesthesia.
  2. Surgeon makes an incision in the scalp to access the skull.
  3. A portion of the skull is removed to access the brain.
  4. The surgeon performs the necessary procedure on the brain, such as tumor removal or repairing a blood vessel.
  5. The skull is then replaced and secured with plates and screws.
  6. The scalp is closed with stitches or staples.
  • After the craniotomy:
  1. Patient wakes up in the recovery room and is monitored closely for any complications.
  2. Patient may experience pain, swelling, and discomfort at the incision site.
  3. Patient may need to stay in the hospital for a few days for observation and recovery.
  4. Patient may need physical therapy or rehabilitation to regain strength and function.
  5. Patient will have follow-up appointments with their neurosurgeon to monitor their progress and discuss any concerns.

What to Ask Your Doctor

  1. What type of craniotomy approach do you recommend for my specific condition?
  2. What are the potential complications associated with the recommended approach?
  3. How common are these complications in your experience?
  4. How will you minimize the risk of complications during the surgery?
  5. What is the recovery process like after this type of craniotomy?
  6. Are there any long-term effects or risks associated with this type of surgery?
  7. How soon can I expect to return to normal activities after the surgery?
  8. Are there any alternative treatment options to consider?
  9. What is your experience and success rate with this type of craniotomy procedure?
  10. Are there any specific precautions or follow-up care I should be aware of after the surgery?

Reference

Authors: Rychen J, Croci D, Roethlisberger M, Nossek E, Potts M, Radovanovic I, Riina H, Mariani L, Guzman R, Zumofen DW. Journal: World Neurosurg. 2018 May;113:163-179. doi: 10.1016/j.wneu.2018.02.016. Epub 2018 Feb 13. PMID: 29452317