Usefulness of the Orbitofrontomalar Approach Associated with Bone Reconstruction for Frontotemporosphenoid Meningiomas

Pellerin, P.; Lesoin, F; Dhellemmes, P; Donazzan, M; Jomin, M

doi:10.1227/00006123-198411000-00016

Cited by 121 publications

(46 citation statements)

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“…During this period, we changed the operative procedure from orbito-fronto-malar (OFM) Bmonobloc^removal to lesser sphenoid wing drilling without complete OFM removal [9,23,24]. The reconstruction procedure used a Btailored^iliac crest graft to rebuild the orbit walls (Fig.…”

Section: Perioperative Reconstructionmentioning

confidence: 99%

Internal and external spheno-orbital meningioma varieties: different outcomes and prognoses

Leroy¹,

Leroy-Ciocanea²,

Baroncini³

et al. 2016

Acta Neurochir

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The internal SOM variety exhibited a reduced total resection rate and a shorter progression-free survival (PFS). Unroofing of the optic canal extended PFS. Among grade I cases, the persistence of a negligible tumour remnant did not alter the probability of recurrence. For superior grades, radiotherapy must be administered in addition to surgery as soon as possible. SOMs require prolonged follow-up. Autologous iliac reconstruction is related to substantial morbidity and could be replaced by prosthetic bone three-dimensional reconstruction.

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Section: Perioperative Reconstructionmentioning

confidence: 99%

Internal and external spheno-orbital meningioma varieties: different outcomes and prognoses

Leroy¹,

Leroy-Ciocanea²,

Baroncini³

et al. 2016

Acta Neurochir

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“…An insertion tendon cuff is also preserved along the insertion line of the temporalis muscle for future reattachment and improved functionality [5,6,25,35].…”

Section: Surgical Techniquementioning

confidence: 99%

The frontotemporal-orbitozygomatic approach: reconstructive technique and outcome

et al. 2012

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“…Many variations have emerged since the original description as a 1-piece or 2-piece procedure. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Most investigators suggested a nonosteoplastic craniotomy, with the exception of 1 group, 17 and the cosmesis of such interventions, principally of temporal muscle atrophy with asymmetry and slumping, resulting in temporal fossa depression is seldom addressed. In addition, the devascularization of the free bone flap with antecedent atrophy and suboptimal healing along the craniotomy line with a heightened risk of infection is not mentioned.…”

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confidence: 99%

Frontotemporal-Orbitozygomatic Approach

Balasingam

McMenomey

Delashaw

2005

Neurosurgery Quarterly

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The frontotemporal-orbitozygomatic (FTOZ) approach developed by Hakuba in 1977 as an osteoblastic bone flap for tumoral and aneurysmal pathologic findings offers a craniotomy with a wide shallow working area and optimal brain exposure with minimal brain retraction. This procedure provides a low vantage point with a wide angle of exposure to the contents of the inferior frontal lobe, parasellar region, cavernous sinus, interpeduncular cisterns, and floor of the anterior and middle fossa. Most procedure variations are fashioned in a nonosteoplastic fashion using deep structures such as the inferior orbital fissure and/or the superior orbital fissures. Unfortunately, published articles have drawn little attention to the cosmesis and complexity of the procedure. A simpler and less timeconsuming FTOZ craniotomy approach compared with previous reports is recommended here. An osteoplastic technique with improved long-term cosmesis that eliminates the necessity of use of the inferior orbital fissures with no need to expose the malar eminence and, if required, translocation of the temporal process of the zygoma rather than removal with the bone flap is discussed. The authors present techniques with cadaveric and skull models for performing a simplified osteoplastic FTOZ craniotomy via 3 procedures (1-piece, 2-piece, and modified) and discuss the merits and use of each procedure. Although the procedures can be performed in a nonosteoplastic fashion, the osteoplastic method is recommended for longterm cosmesis and good functional outcome. The authors' preference for most pathologic lesions treated is the modified procedure because of its simplicity, ease, adequate exposure, and shorter required operating time.T he frontotemporal-orbitozygomatic (FTOZ) approach was developed in 1977 and first introduced into the neurosurgical armamentarium in 1986 by Hakuba and colleagues. 1 It was a 1-piece osteoplastic bone flap with the intent of providing excellent exposure obliquely of the parasellar region and the interpeduncular fossa with the shortest possible working distance. Many variations have emerged since the original description as a 1-piece or 2-piece procedure. 2-17 Most investigators suggested a nonosteoplastic craniotomy, with the exception of 1 group, 17 and the cosmesis of such interventions, principally of temporal muscle atrophy with asymmetry and slumping, resulting in temporal fossa depression is seldom addressed. In addition, the devascularization of the free bone flap with antecedent atrophy and suboptimal healing along the craniotomy line with a heightened risk of infection is not mentioned.This article describes the technical details of performing a simple but easy osteoplastic FTOZ via 3 avenues: 1-piece procedure, 2-piece procedure, and modified 1-piece procedure. The simplicity of the technique is attributed to the lack of need for the use of the inferior orbital fissures in the procedure. Furthermore, the zygomatic arch is not removed separately or as part of the bone flap but is rather translocated with the...

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Usefulness of the Orbitofrontomalar Approach Associated with Bone Reconstruction for Frontotemporosphenoid Meningiomas

Abstract: Seven cases of frontotemporosphenoid meningioma are reported. The principles of the orbitofrontomalar approach and of reconstruction of the orbital cone and of the frontomalar region with an orbitotemporal prop are discussed.

Cited by 121 publications

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Internal and external spheno-orbital meningioma varieties: different outcomes and prognoses

Internal and external spheno-orbital meningioma varieties: different outcomes and prognoses

The frontotemporal-orbitozygomatic approach: reconstructive technique and outcome

Frontotemporal-Orbitozygomatic Approach

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