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A Comparative Study between Supraorbital Keyhole and Pterional Approaches on Anterior Circulation Aneurysms

BACKGROUND: Many different conventional approaches such as the frontal and pterional approaches are used to access anterior circulation aneurysms. Recently, the supraorbital approach has been widely applied to the treatment of anterior circulation aneurysms. This study was done to evaluate which app...

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Autores principales: Genesan, Pravinna, Haspani, Mohammad Saffari Mohammad, Noor, Saiful Razman Mohd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Penerbit Universiti Sains Malaysia 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419883/
https://www.ncbi.nlm.nih.gov/pubmed/30914863
http://dx.doi.org/10.21315/mjms2018.25.5.6
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author Genesan, Pravinna
Haspani, Mohammad Saffari Mohammad
Noor, Saiful Razman Mohd
author_facet Genesan, Pravinna
Haspani, Mohammad Saffari Mohammad
Noor, Saiful Razman Mohd
author_sort Genesan, Pravinna
collection PubMed
description BACKGROUND: Many different conventional approaches such as the frontal and pterional approaches are used to access anterior circulation aneurysms. Recently, the supraorbital approach has been widely applied to the treatment of anterior circulation aneurysms. This study was done to evaluate which approach (pterional or supraorbital) has better outcomes in terms of residual neck post-clipping, cosmetic satisfaction, scar tenderness, complications and functional outcomes. METHODOLOGY: A total of 123 patients were recruited into this study, comprising 82 patients who underwent a pterional approach and 41 patients who underwent a supraorbital approach. Computed tomography angiograms, the modified Rankin Scale, and the visual analogue scale were administered at 6 months to look for residual aneurysm, functional outcomes, scar tenderness, and cosmetic satisfaction. Complication data were collected from patients’ case notes. RESULTS: The mean operating time for the pterional group was 226 min, compared to supraorbital group, which was 192 min (P = 0.07). Cosmetic satisfaction was significantly higher (P = 0.001) in the supraorbital group. There was no significant difference between the supraorbital and pterional groups’ scar tenderness (P = 0.719), residual aneurysm (P = 0.719), or functional outcomes (P = 0.137), and there was no significant difference between the groups in terms of intra-operative and post-operative complications. CONCLUSIONS: The supraorbital group had better cosmetic outcomes and shorter operating times compared to the pterional group.
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spelling pubmed-64198832019-03-26 A Comparative Study between Supraorbital Keyhole and Pterional Approaches on Anterior Circulation Aneurysms Genesan, Pravinna Haspani, Mohammad Saffari Mohammad Noor, Saiful Razman Mohd Malays J Med Sci Original Article BACKGROUND: Many different conventional approaches such as the frontal and pterional approaches are used to access anterior circulation aneurysms. Recently, the supraorbital approach has been widely applied to the treatment of anterior circulation aneurysms. This study was done to evaluate which approach (pterional or supraorbital) has better outcomes in terms of residual neck post-clipping, cosmetic satisfaction, scar tenderness, complications and functional outcomes. METHODOLOGY: A total of 123 patients were recruited into this study, comprising 82 patients who underwent a pterional approach and 41 patients who underwent a supraorbital approach. Computed tomography angiograms, the modified Rankin Scale, and the visual analogue scale were administered at 6 months to look for residual aneurysm, functional outcomes, scar tenderness, and cosmetic satisfaction. Complication data were collected from patients’ case notes. RESULTS: The mean operating time for the pterional group was 226 min, compared to supraorbital group, which was 192 min (P = 0.07). Cosmetic satisfaction was significantly higher (P = 0.001) in the supraorbital group. There was no significant difference between the supraorbital and pterional groups’ scar tenderness (P = 0.719), residual aneurysm (P = 0.719), or functional outcomes (P = 0.137), and there was no significant difference between the groups in terms of intra-operative and post-operative complications. CONCLUSIONS: The supraorbital group had better cosmetic outcomes and shorter operating times compared to the pterional group. Penerbit Universiti Sains Malaysia 2018-09 2018-10-30 /pmc/articles/PMC6419883/ /pubmed/30914863 http://dx.doi.org/10.21315/mjms2018.25.5.6 Text en © Penerbit Universiti Sains Malaysia, 2018 This work is licensed under the terms of the Creative Commons Attribution (CC BY) (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Original Article
Genesan, Pravinna
Haspani, Mohammad Saffari Mohammad
Noor, Saiful Razman Mohd
A Comparative Study between Supraorbital Keyhole and Pterional Approaches on Anterior Circulation Aneurysms
title A Comparative Study between Supraorbital Keyhole and Pterional Approaches on Anterior Circulation Aneurysms
title_full A Comparative Study between Supraorbital Keyhole and Pterional Approaches on Anterior Circulation Aneurysms
title_fullStr A Comparative Study between Supraorbital Keyhole and Pterional Approaches on Anterior Circulation Aneurysms
title_full_unstemmed A Comparative Study between Supraorbital Keyhole and Pterional Approaches on Anterior Circulation Aneurysms
title_short A Comparative Study between Supraorbital Keyhole and Pterional Approaches on Anterior Circulation Aneurysms
title_sort comparative study between supraorbital keyhole and pterional approaches on anterior circulation aneurysms
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419883/
https://www.ncbi.nlm.nih.gov/pubmed/30914863
http://dx.doi.org/10.21315/mjms2018.25.5.6
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