[An en bloc cranio-orbitozygomatic approach: surgical technique and results].

An en bloc cranio-orbitozygomatic approach is described. This technique was applied in seven patients (five basilar artery aneurysms, a trigeminal neuroma, a meningioma of the lesser sphenoid wing). The follow-up period ranged from 3 to 50 months. The patients were retrospectively analyzed from the cosmetic point of view, and submitted to computerized tomography with three dimensional and multiplanar reconstructions. The access provided a wider operative field with a shorter distance to the pathology and possibility of increased angulation of the microscope. The aneurysms could be clipped and the tumors completely removed in all cases. A frontalis muscle paralysis occurred in two cases, as well as a temporalis muscle atrophy in another two patients. There were no enophthalmos or bone flap displacements. The surgical technique is simple and do not require drills, electric saws and mini-plates.

[1]  C. Drake.  Bleeding aneurysms of the basilar artery. Direct surgical management in four cases. 1961. , 1961, The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques.

[2]  R. Spetzler,et al.  Orbitozygomatic craniotomy. Technical note. , 1998, Journal of neurosurgery.

[3]  K. Tanaka,et al.  A surgical technique to avoid postoperative enophthalmos in the cranioorbital approach. Technical note. , 1996, Journal of neurosurgery.

[4]  H. Yonas,et al.  Cranial base approaches to intracranial aneurysms in the subarachnoid space. , 1994, Neurosurgery.

[5]  T. Fukushima,et al.  Extradural temporopolar approach to lesions of the upper basilar artery and infrachiasmatic region. , 1994, Journal of neurosurgery.

[6]  R. Heros,et al.  The Combined Pterional/Anterior Temporal Approach for Aneurysms of the Upper Basilar Complex , 1993 .

[7]  R. Heros,et al.  The combined pterional/anterior temporal approach for aneurysms of the upper basilar complex: technical report. , 1993, Neurosurgery.

[8]  O. Al-Mefty.  The Cranio‐orbital Zygomatic Approach for Intracranial Lesions , 1992 .

[9]  M. Hashimoto,et al.  Orbitozygomatic temporopolar approach for a high basilar tip aneurysm associated with a short intracranial internal carotid artery: a new surgical approach. , 1991, Neurosurgery.

[10]  W. B. Woodhurst,et al.  Combined frontotemporal-orbitozygomatic approach for tumors of the sphenoid wing and orbit. , 1990, Neurosurgery.

[11]  T Suzuki,et al.  A combined orbitozygomatic infratemporal epidural and subdural approach for lesions involving the entire cavernous sinus. , 1989, Journal of neurosurgery.

[12]  L. Close,et al.  A combined frontotemporal and lateral infratemporal fossa approach to the skull base. , 1988, Journal of neurosurgery.

[13]  O. Al-Mefty.  Supraorbital-pterional approach to skull base lesions. , 1987, Neurosurgery.

[14]  M. Yașargil,et al.  Preservation of the frontotemporal branch of the facial nerve using the interfascial temporalis flap for pterional craniotomy. Technical article. , 1987, Journal of neurosurgery.

[15]  A. J. Marchese,et al.  Basilar aneurysm surgery: the subtemporal approach with section of the zygomatic arch. , 1986, Neurosurgery.

[16]  K. Fujitsu,et al.  Zygomatic approach for lesions in the interpeduncular cistern. , 1985, Journal of neurosurgery.

[17]  H. Winn,et al.  The supraorbital approach: technical note. , 1982, Neurosurgery.

[18]  K. Sano.  Temporo-polar approach to aneurysms of the basilar artery at and around the distal bifurcation: technical note. , 1980, Neurological research.

[19]  S. Kobayashi,et al.  Microneurosurgery for aneurysms of the basilar artery. , 1979, Journal of neurosurgery.

[20]  D. Samson,et al.  Microsurgical evaluation of the pterional approach to aneurysms of the distal basilar circulation. , 1978, Neurosurgery.

[21]  M. Yașargil,et al.  Microsurgical pterional approach to aneurysms of the basilar bifurcation. , 1976, Surgical neurology.