Summary
A subtemporal-infratemporal and basal subfrontal approach for the removal of extensive, predominantly extradural cranial base neoplasms is described. This approach was used successfully in six of our patients. The advantages of this approach are extensive exposure of the anterior and mid-cranial base as well as the clivus, direct exposure and management of the ipsilateral petrous and cavernous internal carotid artery (ICA), and access to extracranial vessels for microvascular flap transfer. Disadvantages include prolonged operative time and less control of the contralateral petrous ICA. Six patients with extensive cranial base neoplasms had operations using this technique without any mortality or major permanent morbidity. The value of this approach to patients in terms of control or cure of extensive cranial base tumours has to be proven by long term follow-up.
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Derome PJ, Visot A, Monteil JP, Maestro JL (1987) Management of cranial chordomas. In: Sekhar LN, Schramm VL Jr, (eds) Tumors of the cranial base: diagnosis and treatment. Futura Publishers, New York, pp 607–622
Erba SM, Horton JA, Latchaw RE, Yonas H, Sekhar LN, Schramm V, Pentheny S (1987) Balloon test occlusion of the internal carotid artery with xenon/CT. AJNR (in press)
Fisch U, Kumar A (1985) Infratemporal surgery of the skull base. In: Rand RW (ed) Microsurgery, 3rd Ed. CV Mosby, St. Louis, p 832
Jones NF, Schramm VL Jr, Sekhar LN. (1987) Reconstruction of the cranial base following tumor resection. Br J Plast Surg 40: 155–162
Lang J (1983) Clinical anatomy of the head. Neurocraniumorbit-craniocervical regions. Springer, Berlin Heidelberg New York
Moller AR, Sekhar LN (1987) Monitoring cranial nerve function in removal of tumors of the skull base. Acta Neurochir (Wien) (submitted)
Pellerin P, Lesoin F, Dhellones P,et al (1984) Usefulness of the orbitofrontomalar approach with bone reconstruction of frontotemporosphenoidal meningiomas. Neurosurgery 15: 715–718
Sekhar LN, Schramm VL Jr, Jones NF (1987) A subtemporal-preauricular infratemporal approach to large lateral and posterior cranial base neoplasms. J Neurosurg (in press)
Sekhar LN, Schramm VL Jr, Jones NF,et al (1986) Operative exposure and surgical management of the petrous and upper cervical internal artery. Neurosurg 19: 967–982
Suzuki T, Tokuno H, Hakuba A (1986) The orbitozygomatic infratemporal approach (a new surgical technique). Proceedings of International Symposium on Cavernous Sinus. Ljubljana, Yugoslavia, June 29–July 3
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Sekhar, L.N., Janecka, I.P. & Jones, N.F. Subtemporal—infratemporal and basal subfrontal approach to extensive cranial base tumours. Acta neurochir 92, 83–92 (1988). https://doi.org/10.1007/BF01401977
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DOI: https://doi.org/10.1007/BF01401977