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

Abstract 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 t...

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Autores principales:	Ricardo Brandão Fonseca, Alyne Oliveira Correia, Raysa Siqueira Vieira, José Erivaldo Fonseca dos Santos, Heverty Rocha Alves-Neto, Anajara Ferraz da Silva Vieira, Diego Ramon Ferreira Belém, Marcos Tobias-Machado, Claudio Henrique Fernandes Vidal, Jaques Waisberg
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0bf6abe57a194b2a8e806f6da9574567
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spelling	oai:doaj.org-article:0bf6abe57a194b2a8e806f6da95745672021-12-02T13:20:21ZComparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting10.1038/s41598-021-85115-72045-2322https://doaj.org/article/0bf6abe57a194b2a8e806f6da95745672021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85115-7https://doaj.org/toc/2045-2322Abstract 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.Ricardo Brandão FonsecaAlyne Oliveira CorreiaRaysa Siqueira VieiraJosé Erivaldo Fonseca dos SantosHeverty Rocha Alves-NetoAnajara Ferraz da Silva VieiraDiego Ramon Ferreira BelémMarcos Tobias-MachadoClaudio Henrique Fernandes VidalJaques WaisbergNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ricardo Brandão Fonseca Alyne Oliveira Correia Raysa Siqueira Vieira José Erivaldo Fonseca dos Santos Heverty Rocha Alves-Neto Anajara Ferraz da Silva Vieira Diego Ramon Ferreira Belém Marcos Tobias-Machado Claudio Henrique Fernandes Vidal Jaques Waisberg Comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting
description	Abstract 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.
format	article
author	Ricardo Brandão Fonseca Alyne Oliveira Correia Raysa Siqueira Vieira José Erivaldo Fonseca dos Santos Heverty Rocha Alves-Neto Anajara Ferraz da Silva Vieira Diego Ramon Ferreira Belém Marcos Tobias-Machado Claudio Henrique Fernandes Vidal Jaques Waisberg
author_facet	Ricardo Brandão Fonseca Alyne Oliveira Correia Raysa Siqueira Vieira José Erivaldo Fonseca dos Santos Heverty Rocha Alves-Neto Anajara Ferraz da Silva Vieira Diego Ramon Ferreira Belém Marcos Tobias-Machado Claudio Henrique Fernandes Vidal Jaques Waisberg
author_sort	Ricardo Brandão Fonseca
title	Comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting
title_short	Comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting
title_full	Comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting
title_fullStr	Comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting
title_full_unstemmed	Comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting
title_sort	comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/0bf6abe57a194b2a8e806f6da9574567
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Comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting

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