Validity of the frontolateral approach as a minimally invasive corridor for XXXX .

@entity1 @entity5 @entity75 @entity5254 @entity1653 @entity1317 @entity5578 @entity1779 @entity385
BACKGROUND: Several approaches are described for @entity1653 ( @entity1653 ) varying from a very wide bifrontal craniotomy to minimally invasive endoscopic techniques. The goal of this study was to evaluate the results of the frontolateral approach for @entity1653 . Pitfalls related to this corridor will be described. The impact of @entity5 size and encasement of the anterior cerebral artery complex on the degree of @entity5 removal will be described on the basis of experience with 18 cases. METHODS: Eighteen @entity1 with OGM underwent microsurgical removal using the frontolateral approach. A retrospective study was conducted by analyzing clinical data, neuroimaging studies, operative findings, clinical outcome, and degree of @entity5 removal. FINDINGS: The @entity1 were classified into group A with @entity5 size less than 4 cm in diameter (7 out of 18 cases, 38.9%) and group B with @entity5 size more than 4 cm in diameter (11 out of 18 cases, 61.1%). CSF @entity5254 was observed in three @entity1 (16.7%). Postoperative left frontal @entity1779 occurred in one @entity1 (5.6%) belonging to group A. In another @entity1 (5.6%) belonging to group B, marked @entity75 was evident after dural opening, which necessitated partial right frontal pole resection. @entity5 removal (Simpson grade 1 and 2) was achieved in 14 out of 18 @entity1 (77.8%), while subtotal removal (Simpson grade 3 and 4) was achieved in 4 @entity1 (22.2%). In the 14 @entity1 in whom total removal was achieved, 7 belonged to group A (all 7 @entity1 of group A with 100% removal), while the remaining 7 @entity1 belonged to group B (7 out of 11 @entity1 , 63.6% removal; one of them had anterior cerebral artery complex encasement). The four @entity1 in whom subtotal removal was achieved belonged to group B; three of them showed anterior cerebral artery complex encasement, and one elderly @entity1 had @entity5578 . One @entity1 (5.6%) in group B died from @entity385 after @entity5 removal with anterior cerebral @entity1317 during its dissection from the @entity5 capsule. CONCLUSION: The frontolateral approach has the advantages of both the pterional and conventional bifrontal approaches. The frontolateral approach allows quick and minimally invasive access to @entity1653 less than 4 cm in diameter, and also to @entity5 more than 4 cm in diameter without encasement of the anterior cerebral artery complex. @entity5 size more than 4 cm in diameter and encasement of the anterior cerebral artery complex are limiting factors for the frontolateral approach if @entity5 removal is considered.
