[Minimally Invasive Endoscopic Surgery: The Anterolateral Approach].

The anterolateral keyhole approach has evolved as a minimally invasive strategy for lesions of the anterior skull base and surrounding circulation. In particular, the supraorbital eyebrow approach allows direct access to the frontal skull base through a small craniotomy, while preserving cosmetic outcomes and minimizing surgical morbidity. This review outlined the anatomical concepts, surgical indications, technical nuances, and limitations of the supraorbital eyebrow approach, with particular emphasis on cerebrospinal fluid drainage, instrument selection, and endoscope positioning in a narrow operative corridor. Additionally, the mini-pterional and extended-eyebrow approaches are discussed as complementary options that expand the operative field toward the lateral and Sylvian regions when required. Although minimally invasive approaches offer clear advantages, they should be selected only when surgical efficacy, including the extent of tumor resection, is equivalent to that of a standard craniotomy. Surgeons must also recognize that the management of intraoperative complications, such as bleeding, can be more challenging in a restricted field. Therefore, careful patient selection, thorough anatomical understanding, and stepwise development of experience (from simple cases to complex cases) are essential, particularly for young neurosurgeons. When applied appropriately, the anterolateral keyhole approach is a safe and effective extension of conventional cranial surgery.