Keyhole Craniotomy for Excision of Tumors and Clipping of Aneurysm in Children: An Analysis of Eight Procedures

With improvement in surgical techniques and introduction of new micro-instruments, keyhole craniotomies are gaining favor in neurosurgery. We evaluated the technical and procedural aspects of the supraorbital keyhole approach for eight pediatric patients undergoing excision of tumor and clipping of aneurysm between 2012-2015. The mean age and weight of the patients were 10.0 3.92 yr and 23.97 11.20 Kg respectively. Surgery was performed from the right side in all patients. The mean length of the incision in our series was 2.79 cm 0.09. Maximum tumor diameter was 50 mm. Gross total resection of the tumor was done in 4 (57.14%) and near total in the remaining 3 patients (42.85%). 2 patients (25%) experienced CSF rhinorrhea and other two patients (25%) suffered transitory diabetes insipidus (8%). There was no mortality in our case series. Out of 8 patients, 6 were followed up to 12 months. Recurrence of tumor was encountered only in 1 (14.28%) patient. We observed that the supraorbital keyhole craniotomy is a useful minimally invasive approach to treat selected anterior fossa tumors and aneurysm of the intracranial vessels.