Lateral transzygomatic middle fossa approach and its extensions: Surgical technique and 3D anatomy

Chotai, Silky; Kshettry, Varun R.; Petrak, Alex; Ammirati, Mario

doi:10.1016/j.clineuro.2014.12.014

Cited by 20 publications

(20 citation statements)

References 71 publications

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“…The sheer number of reports has led to much confusion in the literature in terminology." 20 They suggested the following simplified classification: (1) anterolateral extradural approach, (2) anterolateral intradural approach, (3) lateral extradural approach, and (4) lateral intradural approach. 20 el-Kalliny et al classified tumors of the CS into the following: type 1, intracavernous; type 2, interdural; and type 3, invasive.…”

Section: Surgical Planningmentioning

confidence: 99%

“…[8][9][10][11][12][13][14][15][16] Since Parkinson's work in the 1960s, research has enabled improved surgical access of the CS, the lateral wall of the CS and Meckel's cave (MC). 12,[17][18][19][20][21] Surgical approaches and variations thereof have been codified for the various parasellar regions and pathologies. 20 Without modern imaging, pioneer surgeons made difficult treatment decisions based on sometimes "bizarre" clinical findings.…”

Section: Introductionmentioning

confidence: 99%

“…12,[17][18][19][20][21] Surgical approaches and variations thereof have been codified for the various parasellar regions and pathologies. 20 Without modern imaging, pioneer surgeons made difficult treatment decisions based on sometimes "bizarre" clinical findings. 7 It is now possible for magnetic resonance imaging (MRI) to identify the proximal extent of PNS and whether it remains confined within the nerve, permitting more rational surgical decision making.…”

Section: Introductionmentioning

confidence: 99%

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Intracranial Management of Perineural Spread in the Trigeminal Nerve

Redmond

Panizza

2016

J Neurol Surg B

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Since the mid-1960s surgeons have attempted to cure intracranial perineural spread (PNS) of cutaneous malignancies. Untreated patients with trigeminal PNS die from brainstem invasion and leptomeningeal disease. It was understood that resection with clear margins was potentially curative, but early surgical attempts were unsuccessful. The prevailing wisdom considered that this surgery failed to improve the results achieved with radiation therapy alone and was associated with high morbidity. However, with improved imaging, surgical equipment, and better understanding of cavernous sinus (CS) anatomy and access, contemporary surgeons can improve outcomes for this disease. The aim of this paper is to describe a technique to access the interdural compartment of the CS and treat PNS of cutaneous squamous cell carcinoma (cSCC) in the intracranial trigeminal nerve and ganglion. It is based on the experience of the Queensland Skull Base Unit, Australia in managing PNS of cutaneous squamous cell carcinoma of the head and neck (cSCCHN).

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Section: Surgical Planningmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intracranial Management of Perineural Spread in the Trigeminal Nerve

Redmond

Panizza

2016

J Neurol Surg B

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“…Surgical access to lesions in the middle cranial fossa (MCF), petrous apex, and cavernous sinus is usually gained with a temporal or frontotemporal craniotomy to which modifications such as anterior clinoidectomy, anterior petrosectomy, and zygomatic osteotomy are added to improve exposure while minimizing brain retraction. 1 While the indications and benefits of each one of those modifications have been well, [2][3][4] there is little data in the literature to document the impact of each one of those additions to the overall complications profile of those surgeries. Our group has previously evaluated the complications rate associated with an anterior petrosectomy and found no specific morbidity due to the use of an anterior petrosectomy during skull base approaches.…”

Section: Introductionmentioning

confidence: 99%

Indications and Safety of the Zygomatic Osteotomy in Middle Cranial Fossa Surgery: A Retrospective Cohort Review

et al. 2018

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Background Zygomatic osteotomy, an adjunct to middle cranial fossa (MCF) surgical approaches, improves the superior-inferior angle of approach and minimizes temporal lobe retraction. However, a decision-making algorithm for selective use of the zygomatic osteotomy and the impact of the zygomatic osteotomy on surgical complications have not been well documented. Objective We described an algorithm for deciding whether to use a zygomatic osteotomy in MCF surgery and evaluated complications associated with a zygomatic osteotomy. Methods A retrospective review of MCF cases over 11 years at our academic tertiary referral center was conducted. Demographic variables, tumor characteristics, surgical details, and postoperative complications were extracted. Results Of the 87 patients included, 15 (17%) received a zygomatic osteotomy. Surgical trajectory oriented from anterior to posterior (A-P) was significantly correlated with the use of the zygomatic osteotomy. Among the cases approached from A-P, we found (receiver-operating characteristic curve) that the cut-off tumor size that predicted a zygomatic osteotomy was 30 mm. Of the 87 cases included, 15 patients had a complication. The multivariate logistic regression model failed to reveal any significant correlation between complications and zygomatic osteotomies. Conclusions We found that the most important factor determining the use of a zygomatic osteotomy was anticipated trajectory. A-P approaches were most highly correlated with zygomatic osteotomy. Within those cases, a lesion size cut-off of 30 mm was the secondary predicting factor of zygomatic osteotomy use. The odds of suffering a surgical complication were not significantly increased by use of zygomatic osteotomy.

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“…If tumor mass has grown into the infratemporal space with zygomatic arch obstructing the access, there are risks associated with surgical exposure and local resection of these masses [3]. To reduce such risks, we visualized tumor mass and surrounding structures using 3D computer modeling program.…”

Section: Introductionmentioning

confidence: 99%

Surgical excision of osteochondroma on mandibular condyle via preauricular approach with zygomatic arch osteotomy

Park

Han

et al. 2017

Maxillofac Plast Reconstr Surg

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BackgroundOsteochondroma is a benign tumor that tends to develop in mandibular condyle and coronoid process in the craniofacial region. If tumor mass has grown from condyle into the infratemporal space with zygomatic arch obstructing the access, there are risks associated with surgical exposure and local resection of these masses.Case presentationThis study reports on a case of osteochondroma on mandibular condylar head where we treated with surgical excision via preauricular approach with 3D analysis. After the local resection, there were no surgical and post-operative complications until 8-month follow-up period.ConclusionsIn local excision of osteochondroma, our method is a minimally invasive method. It is a good example of osteochondroma treatment.

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Lateral transzygomatic middle fossa approach and its extensions: Surgical technique and 3D anatomy

Cited by 20 publications

References 71 publications

Intracranial Management of Perineural Spread in the Trigeminal Nerve

Intracranial Management of Perineural Spread in the Trigeminal Nerve

Indications and Safety of the Zygomatic Osteotomy in Middle Cranial Fossa Surgery: A Retrospective Cohort Review

Surgical excision of osteochondroma on mandibular condyle via preauricular approach with zygomatic arch osteotomy

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