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Supraorbital trans-eyebrow craniotomy and fluorescence-guided resection of fronto-basal high grade gliomas.
Clin Neurol Neurosurg 2013; 115(9):1586-90CN

Abstract

OBJECT

To determine the effectiveness of fluorescence-guided resection of fronto-basal high grade gliomas by using the supraorbital trans-eyebrow craniotomy.

METHODS

We present a single-institution experience of 6 consecutive patients presenting high grade brain glioma located on the fronto-basal area that were operated through a supraorbital trans-eyebrow craniotomy. Previous to surgery all patients were administered 20mg/kg of 5 aminolevulic acid so microscopic fluorescence-guided resection could be accomplished. Tumors were located on gyrus rectus (3 patients), medial orbital gyrus (2 patients), and anterior orbital gyrus (1 patient).

RESULTS

Despite the narrow surgical corridor, fluorescence was useful in all cases. Fluorescence-guided resection allowed inclusion into the margins of resection of areas previously considered as normal under white light. Complete resection was obtained in 5 patients. No neurological postoperative new deficit was observed in this series. All six cases corresponded to glioblastoma. Only one case of superficial infection with delayed wound healing was reported as complication. All patients expressed a high level of satisfaction related to cosmetic result.

CONCLUSIONS

Fluorescence-guided resection of fronto-basal high grade gliomas can be successfully achieved through supraorbital trans-eyebrow craniotomy. Benefits of supraorbital craniotomy in the management of fronto-basal high grade gliomas as well as usefulness of fluorescence-guided resection through a very narrow corridor are exposed.

Authors+Show Affiliations

Dptment of Neurocurgery, Hospital Universitari i Politècnic la Fe, Valencia, Spain. ricprat@hotmail.com

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

23453153

Citation

Prat-Acín, Ricardo, et al. "Supraorbital Trans-eyebrow Craniotomy and Fluorescence-guided Resection of Fronto-basal High Grade Gliomas." Clinical Neurology and Neurosurgery, vol. 115, no. 9, 2013, pp. 1586-90.
Prat-Acín R, Galeano-Senabre I, Pancucci G, et al. Supraorbital trans-eyebrow craniotomy and fluorescence-guided resection of fronto-basal high grade gliomas. Clin Neurol Neurosurg. 2013;115(9):1586-90.
Prat-Acín, R., Galeano-Senabre, I., Pancucci, G., Evangelista, R., Ayuso-Sacido, A., & Botella, C. (2013). Supraorbital trans-eyebrow craniotomy and fluorescence-guided resection of fronto-basal high grade gliomas. Clinical Neurology and Neurosurgery, 115(9), pp. 1586-90. doi:10.1016/j.clineuro.2013.02.009.
Prat-Acín R, et al. Supraorbital Trans-eyebrow Craniotomy and Fluorescence-guided Resection of Fronto-basal High Grade Gliomas. Clin Neurol Neurosurg. 2013;115(9):1586-90. PubMed PMID: 23453153.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Supraorbital trans-eyebrow craniotomy and fluorescence-guided resection of fronto-basal high grade gliomas. AU - Prat-Acín,Ricardo, AU - Galeano-Senabre,Inmaculada, AU - Pancucci,G, AU - Evangelista,R, AU - Ayuso-Sacido,A, AU - Botella,C, Y1 - 2013/02/26/ PY - 2012/11/01/received PY - 2013/01/01/revised PY - 2013/02/03/accepted PY - 2013/3/5/entrez PY - 2013/3/5/pubmed PY - 2014/4/3/medline KW - 5 Aminolevulic acid KW - Craniotomy KW - Fluorescence KW - Frontal KW - Glioblastoma KW - Supraorbital SP - 1586 EP - 90 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 115 IS - 9 N2 - OBJECT: To determine the effectiveness of fluorescence-guided resection of fronto-basal high grade gliomas by using the supraorbital trans-eyebrow craniotomy. METHODS: We present a single-institution experience of 6 consecutive patients presenting high grade brain glioma located on the fronto-basal area that were operated through a supraorbital trans-eyebrow craniotomy. Previous to surgery all patients were administered 20mg/kg of 5 aminolevulic acid so microscopic fluorescence-guided resection could be accomplished. Tumors were located on gyrus rectus (3 patients), medial orbital gyrus (2 patients), and anterior orbital gyrus (1 patient). RESULTS: Despite the narrow surgical corridor, fluorescence was useful in all cases. Fluorescence-guided resection allowed inclusion into the margins of resection of areas previously considered as normal under white light. Complete resection was obtained in 5 patients. No neurological postoperative new deficit was observed in this series. All six cases corresponded to glioblastoma. Only one case of superficial infection with delayed wound healing was reported as complication. All patients expressed a high level of satisfaction related to cosmetic result. CONCLUSIONS: Fluorescence-guided resection of fronto-basal high grade gliomas can be successfully achieved through supraorbital trans-eyebrow craniotomy. Benefits of supraorbital craniotomy in the management of fronto-basal high grade gliomas as well as usefulness of fluorescence-guided resection through a very narrow corridor are exposed. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/23453153/Supraorbital_trans_eyebrow_craniotomy_and_fluorescence_guided_resection_of_fronto_basal_high_grade_gliomas_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(13)00062-0 DB - PRIME DP - Unbound Medicine ER -