Superior Eyelid Crease Approach for Transobital Neuroendoscopic Surgery of the Anterior Cranial Fossa

Access to the anterior cranial fossa has traditionally required a large exposure of the surgical field, which can be a source of aesthetic and neurologic morbidity. Minimally invasive surgery approaches have been developed to overcome these adverse effects and was, for a long time, represented by endonasal endoscopic surgery. The superior eyelid crease approach of the anterior cranial fossa with supraorbital osteotomy was described in the early 80s as an interesting alternative to the endonasal approach. This keyhole endoscopic approach allows safe and efficient surgery of the orbit, the anterior cranial fossa, and the mesiotemporal lobe. We successfully treated 10 patients with benign tumors of the anterior cranial fossa, with excellent cosmetic results and no complications. This study presents the surgical technique and its potential indication and limits throughout our experience as well as a review of the literature.