Brain Surgery Through an Eyelid

In the continuing effort to make surgery less invasive, physicians at Johns Hopkins Hospital are operating on the brain through a tiny incision in one of the eyelids instead of lifting a large piece of the skull. Named transpalpebral orbitofrontal craniotomy, the procedure allows for access to the middle and front regions of the brain. The cranial cavity is reached through a hole created by removing a small, half-inch to one-inch-square section of skull bone right above the eyebrow. Endoscopic surgery can then be performed with help of previously obtained CT and MRI data. Afterwards, the dural defect is closed with a graft and the piece of bone is placed back in its original position. The procedure is shorter, less invasive and has fewer complications than conventional surgery. Because the incision is made in a natural crease of the eyelid, the resulting scar is hardly visible. So far the surgeons have performed repair of persistent cerebrospinal fluid leaks and pneumocephalus, and biopsy and resection of midline brain tumors in a total of seven patients.
Press release: Shortcut Through Eyelid Gives Surgeons Less-Invasive Approach to Fix Brian Fluid Leaks and Remove Tumors Near Front of Skull…
Article abstract: Transpalpebral Orbitofrontal Craniotomy: A Minimally Invasive Approach to Anterior Cranial Vault Lesions…
Image credit: l@mie