Transpalpebral/Blepharoplasty Incision and Supraorbital Craniotomy for the Treatment of Ethmoidal Dural Arteriovenous Fistulas: A Case Series.

Autor:	Hagstrom R; Department of Neurosurgery, NYU Langone Health, New York , New York , USA., Nossek E; Department of Neurosurgery, NYU Langone Health, New York , New York , USA., Rutledge CW; Department of Neurosurgery, NYU Langone Health, New York , New York , USA., Ponchione E; Department of Neurosurgery, NYU Langone Health, New York , New York , USA., Suryadevara C; Department of Neurosurgery, NYU Langone Health, New York , New York , USA., Kremer C; Department of Neurosurgery, NYU Langone Health, New York , New York , USA., Alcon A; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York , New York , USA., Sharashidze V; Department of Neurology, NYU Langone Health, New York , New York , USA., Shapiro M; Department of Radiology, NYU Langone Health, New York , New York , USA., Raz E; Department of Radiology, NYU Langone Health, New York , New York , USA., Nelson PK; Department of Radiology, NYU Langone Health, New York , New York , USA., Staffenberg DA; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York , New York , USA., Riina HA; Department of Neurosurgery, NYU Langone Health, New York , New York , USA.
Jazyk:	angličtina
Zdroj:	Operative neurosurgery (Hagerstown, Md.) [Oper Neurosurg (Hagerstown)] 2024 Sep 01; Vol. 27 (3), pp. 303-308. Date of Electronic Publication: 2024 Feb 20.
DOI:	10.1227/ons.0000000000001103
Abstrakt:	Background and Objectives: Inherent complex angioarchitecture associated with ethmoidal dural arteriovenous fistulas (dAVFs) can make endovascular treatment methods challenging. Many surgical approaches are accompanied by unfavorable cosmetic results such as facial scarring. Blepharoplasty incision of the eyelid offers a minimal, well-hidden scar compared with other incision sites while offering the surgeon optimal visualization of pathogenic structures. This case series aims to report an initial assessment of the safety and efficacy of supraorbital craniotomy by blepharoplasty transpalpebral (eyelid) incision for surgical disconnection of ethmoidal dAVFs. Methods: Retrospective chart review was conducted for all patients who underwent blepharoplasty incision and craniotomy for disconnection of ethmoidal dAVFs at our institution between October 2011 and February 2023. Patient charts and follow-up imaging were reviewed to report clinical and angiographic outcomes as well as periprocedural and follow-up complications. Results: Complete obliteration and disconnection of ethmoidal dAVF was achieved in all 6 (100%) patients as confirmed by intraoperative angiogram with no resulting morbidity or mortality. Periprocedural complications included one case of transient nasal cerebrospinal fluid leak that was self-limiting and resolved before discharge without intervention. Conclusion: Surgical treatment for ethmoidal dAVFs, specifically by transpalpebral incision and supraorbital craniotomy, is a safe and effective treatment option and affords the surgeon greater access to the floor of the anterior fossa when necessary. In addition, blepharoplasty incision addressed patient concerns for facial scarring compared with other incision sites by creating a more well-hidden, minimal scar in the natural folds of the eyelid for patients with an eyelid crease. (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)
Databáze:	MEDLINE
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