利用小骨窗的“门洞效应”即眶上锁孔入路(Supraorbital keyhole approach,SKA)治疗前循环动脉瘤,创伤小路径短,能直接到达病变,减轻了脑牵拉,同时去除眶顶板的骨性突起,可以增加显露范围及视角,与标准翼点入路及眶颧入路比较,减少了与手术入路相关的并发症,而且显露范围及手术致残率并无明显差异。手术显微镜及内窥镜的利用又解决了照明及视野的问题。随着专用于锁孔入路的同轴控制显微手术器械的应用,SKA治疗Willis环前循环动脉瘤更能显示其优越性。 A small aneurysm with a small trabecular path, which is directly treated by Supraorbital keyhole approach (SKA) using the “hole effect” of the small bone window, can directly reach the lesion and relieve the brain traction and remove the orbital roof Of the bony protrusion, can increase the scope and perspective of exposure, and the standard pterional approach and orbital zygomatic approach compared to reduce the complications associated with surgical approach, and revealed the scope and surgical disability rate no significant difference. The use of surgical microscopes and endoscopes solves the lighting and vision problems. With the use of coaxially controlled microsurgery designed for keyhole access, SKA’s treatment of the Willis anterior circulation aneurysm is even more indicative of its superiority.