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Combined orbito-frontal, sub- and infratemporal fossa approach to skull base neoplasms

Surgical technique and clinical application

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Neoplasms located along the antero-lateral skull base, with probable involvement of the orbit and with extension into the pterygoid and/or infratemporal fossa can usually not be sufficiently exposed using standard neurosurgical or otosurgical approaches, which is why combined approaches to these skull base targets have been developed in the recent past. In this report we describe our experience, using a combined orbito-frontal, sub- and infratemporal fossa approach which, starting with a pre-auricular incision and a standard pterional craniotomy, is extended to an extensive osteoplastic enbloc resection of the orbito-zygomatic area allowing for direct visualisation of the antero-temporo-lateral skull base from the orbital cavity to the depth of the infratemporal and pterygoid fossa. The surgical technique as well as the clinical experiences accumulated with this approach are described.

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  1. Alaywan M, Sindou M (1990) Fronto-temporal approach with orbito-zygomatic renoval: Surgical anatomy. Acta Neurochir (Wien) 104: 79–83

    Google Scholar 

  2. Al-Mefty O, Fox JL (1985) Superolateral orbital exposure and reconstruction. Surg Neurol 23: 609–513

    PubMed  Google Scholar 

  3. Fish U, Pillsbury HC (1979) Infratemporal fossa approach to lesions in the temporal bone and base of the skull. Arch Otolaryngol 105: 99–107

    PubMed  Google Scholar 

  4. Hakuba A, Liu SS, Nishimura S (1986) The orbitozygomatic infra-temporal approach: a new surgical technique. Surg Neurol 26: 271–276

    PubMed  Google Scholar 

  5. Hakuba A, Nishimura S, Jojang B (1988) A combined retroauricular and preauricular transpetrosal-transtentorial approach to clivus meningeomas. Surg Neurol 30: 108–116

    PubMed  Google Scholar 

  6. Jackson IT, Hide TAH (1982) A systematic approach to tumours of the base of the skull. J Max-Fac Surg 10: 92–98

    Google Scholar 

  7. Samii M, Ammirati M (1988) The combined supra-infratentorial pre-sigmoid sinus avenue to the petro-clival region. Surgical technique and clinical applications. Acta Neurochir (Wien) 95: 6–12

    Google Scholar 

  8. Sekhar LN, Estonillo R (1986) Transtemporal approach to the skull base: Anantomical study. Neurosurgery 19: 799–808

    PubMed  Google Scholar 

  9. Sekhar LN, Schramm Jr VL, Jones NF (1987) Subtemporal preauricular infratemporal fossa approach to large lateral and posterior skull base neoplasms. J Neurosurg 67: 488–489

    PubMed  Google Scholar 

  10. Sekhar LN, Janecka IP, Jones NF (1988) Subtemporal-infratemporal and basal subfrontal approach to to extensive cranial base tumours. Acta Neurochir (Wien) 92: 83–92

    Google Scholar 

  11. Yaşargil MG, Reichmann MV, Kubik S (1987) Preservation of the frontotemporal branch of the facial nerve using the interfascial temporalis flap for pterional craniotomy. J Neurosurg 67: 463–465

    PubMed  Google Scholar 

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Seifert, V., Dietz, H. Combined orbito-frontal, sub- and infratemporal fossa approach to skull base neoplasms. Acta neurochir 114, 139–144 (1992).

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