The challenges encountered in performing minimally invasive approaches, such as supraorbital minicraniotomy (SOMC), in services without adequate equipment are rarely reported in the literature. This study analyzes the viability of SOMC in the treatment of
cerebral aneurysms, using exactly the same resources as pterional
craniotomy (PC). The results of these two techniques are compared. 35 patients underwent SOMC, compared to 50 patients underwent CP (100
aneurysms in total), using the same microsurgical instruments. The following variables were compared:
operative time, angiographic cure, length of intensive care unit stay during the post-operative period, surgical complications, length of
hospital stay after surgery until hospital discharge, intraoperative
aneurysm rupture, aesthetic satisfaction with the
scar, and neurological status at discharge. SOMC had a significantly shorter
operative time in relation to PC (213.9 ± 11.09 min and 268.6 ± 15.44 min, respectively) (p = 0.0081).With respect to the cosmetic parameters assessed by the Visual Analog Scale, the average for SOMC was 94.12 ± 1.92 points, and the average for PC was 83.57 ± 4.75 points (p = 0.036). SOMC was as effective as PC in relation to successful
aneurysm clipping (p = 0.77). The SOMC technique did not show advantages over PC in any other variable. Even in a general neurosurgery service lacking a specific structure for
minimally invasive surgeries, SOMC was feasible and effective for treating
intracranial aneurysms, using the same set of microsurgical instruments used for PC, obtaining better results in operating time and cosmetic satisfaction.