NS-05: EXPERIENCE OF USING THE SUPRAORBITAL ENDOSCOPIC-ASSISTED APPROACH IN CHIDREN

Supraorbital eyebrow approach is used in neurosurgical practice for subfrontal approach to the lesions located in sellar and suprasellar region predominantly extending to the anterior fossa. This approach is used in children infrequently because of the narrow surgical corridor and potential hazard to cosmetic view. The use of endoscopic assistance allows to expand the indications to the surgery and reduce the invasiveness of the surgery. Between December 2012 and June 2014, 7 patients were operated in Burdenko neurosurgical Institute via the supraorbital approach with endoscopic assistance (ranged 9 months - 16 years). Using endoscopic assistance for removal of optic pathway tumors (2 patients) helps to preserve visual function at the preoperative level, and to significantly reduce the tumor size. 2 patients underwent supraorbital craniotomy via an eyebrow incision and had a gross total resection of craniopharyngiomas. The use of neuronavigation helped in 2 cases of open biopsies to choose the right direction for biopsy sampling. Patients with germ cell tumors underwent chemoradiotherapy according to treatment Protocol for germinomas. In 1 case with endosupraparasellar arachnoid cyst it was possible to perform fenestration in several avascular areas and achieve communication with basal arachnoid cisterns. Furthermore, this keyhole approach with the use of neuronavigation is advantageous by a rapid postoperative recovery of the patients and very good cosmetic result. CONCLUSIONS: This approach with endoscopic assistance is a usefull for small suprasellar lesions, less traumatic, has good cosmetic results and can be used in infants.