Abstract
Background: The supraorbital keyhole approach represents a paradigm shift in the surgical management of anterior skull base lesions, combining the principles of minimal access surgery with targeted anatomical corridors. This technical note describes our institutional experience and operative nuances of this approach.
Methods: We describe our stepwise operative protocol for the supraorbital keyhole approach performed through an eyebrow skin incision. Positioning, craniotomy design, dural opening, intradural dissection, and closure are each outlined in detail. An illustrative case of an olfactory groove meningioma is presented to demonstrate key technical principles.
Conclusions: With meticulous preoperative planning, appropriate patient selection, and integration of endoscopy, the supraorbital keyhole approach affords adequate access to suprasellar and anterior skull base pathology while minimising approach-related morbidity.
