The orbitozygomatic infratemporal fossa approach: a quantitative anatomical study

Honeybul, Stephen; Neil‐Dwyer, G.; Lees, Peter; Evans, B.T.; Lang, Dorothy

doi:10.1007/bf01411735

Cited by 63 publications

(24 citation statements)

References 60 publications

(67 reference statements)

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“…Over the past 20 years, there has been a shift toward a more aggressive and multimodality approach to malignant lesions of the skull base. [9][10][11][12][13][14] There have been several series in the past decade that have reported experiences with skull base lesions without restricting the analysis to a particular region of the skull base. [15][16][17] Although authors have discussed approaches to coma (HGS) histology, early complications of therapy, including those related to chemotherapy or radiation therapy, dural tumor invasion, and central nervous system invasion ( Table 6).…”

Section: Overall Survivalmentioning

confidence: 98%

Malignant Tumors of the Anterolateral Skull Base

et al. 2010

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It is our belief that anterolateral skull base malignancies comprise a distinct group of tumors. These lesions should be analyzed separately from central anterior skull base lesions and temporal bone malignancies. With a multimodality treatment protocol, acceptable survivals may be obtained that are comparable to results that have been reported for tumors involving less difficult areas of the skull base.

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Section: Overall Survivalmentioning

confidence: 98%

Malignant Tumors of the Anterolateral Skull Base

et al. 2010

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“…3,[10][11][12][13][14][15] The quantitative interpretations of these surgical procedures, which intend to ''extend'' the exposure of the standard pterional craniotomy, are much in vogue now. 4,5,13 Schwartz et al 5 used a frameless stereotactic system to measure the area of exposure associated with removal of the orbital roof compared with the zygomatic arch. They sequentially performed a frontotemporal craniotomy (inclusive of removing the entire greater sphenoid wing), then removed the superior and lateral walls of the orbit, followed by resection of the zygomatic arch.…”

Section: Discussionmentioning

confidence: 99%

When Is Posterolateral Orbitotomy Useful in a Pterional Craniotomy? A Morphometric Study

et al. 2012

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Adding posterolateral orbitotomy to pterional craniotomy allows greater exposure of the anterolateral skull base. However, there is a paucity of literature quantifying the relative benefit of adding posterolateral orbitotomy for various surgical targets. Our study is a step to address this issue. We performed dissections of five cadaveric heads (10 sides). The anterior communicating artery (A-Com) complex, posterior chiasm (anterior third ventricular region), ipsilateral optic canal, and ipsilateral supraclinoid internal carotid artery (ICA) bifurcation were chosen as targets. A pterional craniotomy was performed and the targets were morphometrically analyzed. Subsequently, posterolateral orbitotomy was done and analysis repeated. The field of view and measurements quantifying the angle of attack were compared. Addition of orbitotomy to pterional craniotomy increased the angle of exposure to ICA bifurcation, anterior third ventricular region, and A-Com complex by average of 15%, 29%, and 50%, respectively. Our study shows the addition of a posterolateral orbitotomy to the pterional craniotomy improves the angle of attack to the anterior third ventricular region and the A-Com complex, thus supporting the use of orbitopterional craniotomy for suprasellar lesions extending into anteroinferior third ventricle and A-Com aneurysms that point superiorly/posteriorly.

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“…25 It also decreases the operative distance to the suprasellar target, increasing surgical freedom and the ability of the surgeon to dissect the tumor from vital structures. 11 This approach may be particularly useful in the treatment of craniopharyngiomas because these lesions extend superiorly and posteriorly toward or into the third ventricle. Other approaches have been used to expose high retrochiasmatic craniopharyngiomas.…”

Section: Discussionmentioning

confidence: 99%

Modified orbitozygomatic craniotomy for craniopharyngioma resection in children

Golshani

Lalwani

Delashaw

et al. 2009

PED

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Object In this study, the authors evaluated the efficacy and safety of modified orbitozygomatic craniotomy for resection of craniopharyngioma in children. Methods A prospective, institutional review board–approved database was retrospectively reviewed for pediatric patients undergoing craniopharyngioma resection performed by a single surgeon. Results Ten patients underwent craniopharyngioma resection surgery between July 2000 and January 2006 (4 girls and 6 boys, ages 1.5–17 years). Nine patients presented to the authors' institution, and 1 patient was referred after surgery and radiation therapy were administered elsewhere. Nine patients presented with visual field deficits (2 with unilateral or bilateral light perception only) and 5 with endocrine dysfunction. Eight patients had large tumors that significantly displaced the optic chiasm and hypothalamus. All patients underwent a modified frontotemporal orbitozygomatic osteotomy in a single piece. The lamina terminalis was opened in 4 patients with third ventricular extension. One patient required a staged transsphenoidal operation to remove residual tumor in the sella turcica, and 1 patient underwent a contralateral subtemporal approach to resect a daughter lesion in the prepontine cistern. Complete radiographic resection was achieved in all patients. Follow-up averaged 55 months (range 12–95 months). Vision was improved in 8 patients and remained stable in 2. All patients had postoperative endocrine dysfunction. One patient experienced transient cranial nerve IV palsy and 1 suffered a small caudate stroke 5 months after surgery without sequelae. Two patients experienced polyphagia and weight gain without other symptoms of hypothalamic dysfunction. There were no other new neurological deficits. Conclusions Modified orbitozygomatic craniotomy provides excellent exposure of the suprasellar region with minimal brain retraction, allowing complete resection of craniopharyngiomas with good visual and neurological results.

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The orbitozygomatic infratemporal fossa approach: a quantitative anatomical study

Cited by 63 publications

References 60 publications

Malignant Tumors of the Anterolateral Skull Base

Malignant Tumors of the Anterolateral Skull Base

When Is Posterolateral Orbitotomy Useful in a Pterional Craniotomy? A Morphometric Study

Modified orbitozygomatic craniotomy for craniopharyngioma resection in children

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