Modifications to the orbitozygomatic approach. Technical note

The orbitozygomatic craniotomy is one of the workhorse approaches of skull base surgery, providing wide, multidirectional access to the anterior and middle cranial fossae as well as the basilar apex. Complete removal of the orbitozygomatic bar increases the angles of exposure, decreases the working...

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Bibliographic Details
Published inJournal of neurosurgery Vol. 99; no. 5; p. 924
Main Authors Lemole, Jr, G Michael, Henn, Jeffrey S, Zabramski, Joseph M, Spetzler, Robert F
Format Journal Article
LanguageEnglish
Published United States 01.11.2003
Subjects
Brain Diseases - pathology
Brain Diseases - surgery
Craniotomy - methods
Humans
Orbit - pathology
Orbit - surgery
Skull Base - pathology
Skull Base - surgery
Zygoma - pathology
Zygoma - surgery
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Summary:The orbitozygomatic craniotomy is one of the workhorse approaches of skull base surgery, providing wide, multidirectional access to the anterior and middle cranial fossae as well as the basilar apex. Complete removal of the orbitozygomatic bar increases the angles of exposure, decreases the working depth of the surgical field, and minimizes brain retraction. In many cases, however, only a portion of the exposure provided by the full orbitozygomatic approach is needed. Tailoring the extent of the bone resection to the specific lesion being treated can help lower approach-related morbidity while maintaining its advantages. The authors describe the technical details of the supraorbital and subtemporal modified orbitozygomatic approaches and discuss the surgical indications for their use. Modifications to the orbitozygomatic approach are an example of the ongoing adaptation of skull base procedures to general neurosurgical practice.
ISSN:0022-3085
DOI:10.3171/jns.2003.99.5.0924