Single piece fronto-temporo-orbito-zygomatic craniotomy: a personal experience and review of surgical technique

Sharma, Manish; Shastri, Sridhar

doi:10.1080/02688697.2018.1468017

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…Therefore, several variants arose recently for customizing the approach upon the lesion and improving cavernous sinus exposure via also exploiting anterolateral surgical corridors, as seen in the intradural petrosectomy described by Steiger et al [ 131 , 132 , 133 ] and its variants [ 134 , 135 ].…”

Section: Discussionmentioning

confidence: 99%

Midline Skull Base Meningiomas: Transcranial and Endonasal Perspectives

Mastantuoni

Cavallo

Esposito

et al. 2022

Cancers

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Skull base meningiomas have always represented a challenge for neurosurgeons. Despite their histological nature, they may be associated with unfavorable outcomes due to their deep-seated location and the surrounding neurovascular structures. The state of the art of skull base meningiomas accounts for both transcranial, or high, and endonasal, or low, routes. A comprehensive review of the pertinent literature was performed to address the surgical strategies and outcomes of skull base meningioma patients treated through a transcranial approach, an endoscopic endonasal approach (EEA), or both. Three databases (PubMed, Ovid Medline, and Ovid Embase) have been searched. The review of the literature provided 328 papers reporting the surgical, oncological, and clinical results of different approaches for the treatment of skull base meningiomas. The most suitable surgical corridors for olfactory groove, tuberculum sellae, clival and petroclival and cavernous sinus meningiomas have been analyzed. The EEA was proven to be associated with a lower extent of resection rates and better clinical outcomes compared with transcranial corridors, offering the possibility of achieving the so-called maximal safe resection.

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Section: Discussionmentioning

confidence: 99%

Midline Skull Base Meningiomas: Transcranial and Endonasal Perspectives

Mastantuoni

Cavallo

Esposito

et al. 2022

Cancers

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“…The FOZ approach may be considered an extensive modification of the classic pterional craniotomy. Since its original description, it has rapidly evolved and is now considered the gold standard access to lateral skull base lesions [16]. It provides a better exposure with a multidirectional surgical corridor, and a wide working space with minimal brain retraction.…”

Section: Discussionmentioning

confidence: 99%

“…As previously mentioned, Hakuba [15] first systematically described this approach for the treatment of parasellar and interpeduncular fossa lesions, aiming for a better anatomical exposure of the anterior cranial base compared to the classic pterional and subtemporal approaches [9,16,28,29]. However, some authors recommend a two-piece craniotomy [15,23] while others prefer a single-piece craniotomy.…”

Section: Discussionmentioning

confidence: 99%

“…The fronto-orbito-zygomatic (FOZ) approach is commonly used in order to obtain safe access to the lateral skull base and ITF, considering that it provides a wide working space and a multidirectional surgical corridor to resect these complex intra-and extra-cranial tumours [12][13][14][15][16]. The wide bone resection of the FOZ approach provides a minimal brain retraction and several techniques have been described, including single-piece and two-piece craniotomy.…”

Section: Introductionmentioning

confidence: 99%

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Fronto-orbito-zygomatic (FOZ) approach for infratemporal fossa lesions extending to middle cranial fossa: our experience and review of literature

Mancini

Marini

Paracino

et al. 2022

Neurol Neurochir Pol.

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Aim of the study. Tumours of the infratemporal fossa (ITF) are rare and include primary tumours, contiguity lesions and metastases. Surgical resection is the gold standard. The fronto-orbito-zygomatic (FOZ) approach is commonly used in order to obtain safe access to the lateral skull base and ITF to resect intra-and extra-cranial tumours. We here describe our series of ITF lesions extending to the middle cranial fossa and/or orbit, treated by single-or two piece FOZ. Material and methods.All cases of single-or two-piece FOZ approach for an infratemporal fossa lesion extending to the middle cranial fossa operated at our Institution from January 2014 to January 2018 were retrospectively reviewed. The follow-up was for a minimum of four months and a maximum of 60 months. The inclusion criteria were lesions involving the ITF with an extension to the middle cranial fossa and/or orbit. Baseline characteristics of patients, tumour localisation, tumour extension, diffusion route, histology, extent of tumour resection, postoperative treatment, and post-operative complications were evaluated.Results. Nine patients underwent a surgical procedure with a FOZ approach, two of them with a single-piece approach and the remainder with a two-piece one. All patients had an ITF localisation. Gross total removal (GTR) was achieved in 7/9 patients. Only one patient, with non-total removal (NTR), underwent radiotherapy. Conclusions.For the treatment of ITF fossa tumours extending to the orbit and or middle cranial fossa, we believe that both FOZ techniques are effective and allow a good medial extension toward the cavernous sinus and parasellar region. But a two--piece craniotomy may ensure a more medial extension and a wider angle of work compared to a one-piece craniotomy.

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