[Respective indications of orbital and/or zygomatic arch removal combined with fronto-pteriono-temporal approaches. 58 cases].
Orbito- and or zygomatic arch removal associated to fronto-pteriono-temporal craniotomy can be useful to minimize brain retraction and achieve optimal exposure with the shortest possible distance and the most adequate view angle, in the approa-ch of difficult lesions located in the vicinity of the skull base via a supratentorial route. Fifty-eight patients admitted for such difficult lesions were operated on by the authors between 1988 and 1993 using orbital and/or zygomatic removal. Mortality rate was 1,7%. Complications due to orbital and/or zygomatic removal amounted at 15%, but were mostly transient. Sequels owned to excessive brain retraction were less than 10%. No bony cosmetic sequel was observed. From this experience, the authors suggest the respective indications orbit-zygomatic: removal for access to the cavernous sinus, supra-sellar region, tentorial notch, inter-peduncular cistern; simple orbital arch removal for access to complex aneurysms of the anterior circulation, to mesio-temporal lesions; simple zygoma arch removal for approaching infra-temporal lesions, the Meckel's cave, the circumpeduncular cistern and aneurysms of the P2 portion of the posterior cerebral artery.
Emery
E
E
Service de Neurochirurgie A, Hôpital Neurologique et Neurochirurgical Pierre-Wertheimer, Lyon.
Alaywan
M
M
Sindou
M
M
D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D003399:Craniotomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005624:Frontal Bone / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D013100:Sphenoid Bone / Q000000981:diagnostic imaging / Q000601:surgery; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D015050:Zygoma / Q000000981:diagnostic imaging / Q000601:surgery*