Background: The purely endoscopic eyebrow supraorbital approach is an alternative to both the endoscopic endonasal and eyebrow microsurgical routes to the anterior and middle cranial base. It combines an enhanced visualization provided by the endoscope and the absence of cerebrospinal fluid (CSF) leaks and nasal complications.
Methods: A trans-eyebrow 2-cm craniotomy is designed to allow the placement of a straight endoscope and visualize the skull base from the cribriform plate to the mesiotemporal lobe.
Result: Visualization is considerably improved, while the keyhole mini-invasive concept is respected.
Conclusion: The purely endoscopic eyebrow supraorbital keyhole approach is a valuable and alternative minimally invasive route to anterior and middle skull base lesions.