Skip to main content
SpringerLink
Log in

The Fronto-Temporo-Orbito-Zygomatic Approach

  • Chapter
  • First Online:
Cranio-Orbital Mass Lesions

  • 181 Accesses

Abstract

The fronto-temporo-orbito-zygomatic (FTOZ) approach is an extension of the pterional approach. It is commonly used to gain wider access to anterolateral skull base lesions involving the apex of the orbit, the paraclinoid and parasellar regions, the apex of the basilar artery, the cavernous sinus, and the middle and anterior cranial fossa, with minimal retraction of the cerebral parenchyma. Technique and related anatomy are described in the chapter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Jane JA, Park TS, Pobereskin LH, Winn HR, Butler AB. The supraorbital approach: technical note. Neurosurgery. 1982;11(4):537–42.

    Article  CAS  PubMed  Google Scholar 

  2. Al-Mefty O. Supraorbital-pterional approach to skull base lesions. Neurosurgery. 1987;21(4):474–7. https://doi.org/10.1227/00006123-198710000-00006.

    Article  CAS  PubMed  Google Scholar 

  3. Al-Mefty O, Anand VK. Zygomatic approach to skull-base lesions. J Neurosurg. 1990;73(5):668–73. https://doi.org/10.3171/jns.1990.73.5.0668.

    Article  CAS  PubMed  Google Scholar 

  4. Pellerin P, Lesoin F, Dhellemmes P, Donazzan M, Jomin M. Usefulness of the orbitofrontomalar approach associated with bone reconstruction for frontotemporosphenoid meningiomas. Neurosurgery. 1984;15(5):715–8. https://doi.org/10.1227/00006123-198411000-00016.

    Article  CAS  PubMed  Google Scholar 

  5. Hakuba A, Liu SS, Nishimura S. The orbitozygomatic infratemporal approach: technique a new surgical technique. Surg Neurol. 1986;26(3):271–6. https://doi.org/10.1016/0090-3019(86)90161-8.

    Article  CAS  PubMed  Google Scholar 

  6. Alaywan M, Sindou M. Fronto-temporal approach with orbito-zygomatic removal surgical anatomy. Acta Neurochir. 1990;104:79–83. https://doi.org/10.1007/BF01842824.

    Article  CAS  PubMed  Google Scholar 

  7. McDermott MW, Durity FA, Rootman J, Woodhurst WB. Combined frontotemporal-orbitozygomatic approach for tumors of the sphenoid wing and orbit. Neurosurgery. 1990;26:107. https://doi.org/10.1097/00006123-199001000-00015.

    Article  CAS  PubMed  Google Scholar 

  8. Zabramski JM, Sankhla SK, Cabiol J, Spetzler RF. Orbitozygomatic craniotomy technical note. J Neurosurg. 1998;89(2):336–41. https://doi.org/10.3171/jns.1998.89.2.0336.

    Article  CAS  PubMed  Google Scholar 

  9. Seçkin H, Avci E, Uluç K, Niemann D, Başkaya MK. The work horse of skull base surgery: orbitozygomatic approach. Technique, modifications, and applications. Neurosurg Focus. 2008;25(6):E4. https://doi.org/10.3171/FOC.2008.25.12.E4.

    Article  PubMed  Google Scholar 

  10. Ammirati M, Spallone A, Ma J, Cheatham M, Becker D. An anatomicosurgical study of the temporal branch of the facial nerve. Neurosurgery. 1993;33(6):1038–44. https://doi.org/10.1227/00006123-199312000-00012.

    Article  CAS  PubMed  Google Scholar 

  11. Oikawa S, Kobayashi S. Retrograde dissection of the temporalis muscle preventing muscle atrophy for pterional craniotomy technical note. J Neurosurg. 1996;84(2):297–9. https://doi.org/10.3171/jns.1996.84.2.0297.

    Article  CAS  PubMed  Google Scholar 

  12. Kadri PAS, Al-Mefty O. The anatomical basis for surgical preservation of temporal muscle. J Neurosurg. 2004;100(3):517–22. https://doi.org/10.3171/jns.2004.100.3.0517.

    Article  PubMed  Google Scholar 

  13. Spetzler RF, Lee KS. Reconstruction of the temporalis muscle for the pterional craniotomy technical note. J Neurosurg. 1990;73(4):636–7. https://doi.org/10.3171/jns.1990.73.4.0636.

    Article  CAS  PubMed  Google Scholar 

  14. Maccarty CS. Surgical techniques for removal of intracranial meningiomas. Clin Neurosurg. 1959;7:100–11. https://doi.org/10.1093/neurosurgery/7.cn_suppl_1.100.

    Article  CAS  PubMed  Google Scholar 

  15. MacCarty CS. Meningiomas of the sphenoidal ridge. J Neurosurg. 1972;36(1):114–20. https://doi.org/10.3171/jns.1972.36.1.0114.

    Article  CAS  PubMed  Google Scholar 

  16. Tanriover N, Ulm AJ, Rhoton AL, Kawashima M, Yoshioka N, Lewis SB. One-piece versus two-piece orbitozygomatic craniotomy: quantitative and qualitative considerations. Neurosurgery. 2006;58(SUPPL 2):ONS-229. https://doi.org/10.1227/01.NEU.0000210010.46680.B4.

    Article  Google Scholar 

  17. Sekhar LN, Kalia KK, Yonas H, Wright DC, Ching H. Cranial base approaches to intracranial aneurysms in the subarachnoid space. Neurosurgery. 1994;35(3):472–83. https://doi.org/10.1227/00006123-199409000-00016.

    Article  CAS  PubMed  Google Scholar 

  18. Luzzi S, Lucifero AG, Spina A, et al. Cranio-orbito-zygomatic approach: core techniques for tailoring target exposure and surgical freedom. Brain Sci. 2022;12(3):405. https://doi.org/10.3390/brainsci12030405.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Lemole GM, Henn JS, Zabramski JM, Spetzler RF. Modifications to the orbitozygomatic approach. J Neurosurg. 2003;99(5):924–30. https://doi.org/10.3171/jns.2003.99.5.0924.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Neurosurgery, Department of Neurological Sciences, University of Rome Sapienza, Rome, Italy

    Roberto Delfini, Andrea Gennaro Ruggeri & Sara Iavarone

Authors
  1. Roberto Delfini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea Gennaro Ruggeri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sara Iavarone
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Dept. of Neuroscience, University of Naples Federico II, Naples, Italy

    Giulio Bonavolontà

  2. Dept. of Neuroscience, University of Naples Federico II, Naples, Italy

    Francesco Maiuri

  3. Dept. of Neuroscience, University of Naples Federico II, Naples, Italy

    Giuseppe Mariniello

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Delfini, R., Ruggeri, A.G., Iavarone, S. (2023). The Fronto-Temporo-Orbito-Zygomatic Approach. In: Bonavolontà, G., Maiuri, F., Mariniello, G. (eds) Cranio-Orbital Mass Lesions. Springer, Cham. https://doi.org/10.1007/978-3-031-35771-8_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-35771-8_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-35770-1

  • Online ISBN: 978-3-031-35771-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation