Optimization of the operative corridor for the resection of craniopharyngiomas in children: the combined frontoorbitozygomatic temporopolar approach. Technical note.
Complete extirpation of tumor remains the primary goal of neurosurgeons in treating intracranial craniopharyngiomas. The intimate relationship of these lesions with the structures of the skull base and the difficulties of obtaining adequate operative visualization often make total removal an elusive goal. The authors describe the use of a combined fronto-orbitozygomatic temporopolar craniotomy to maximize the operative corridor and thereby increase the probability of maximum tumor resection without morbidity and mortality. They applied this approach in four children with craniopharyngiomas that involved the sellar and parasellar, third ventricle, cavernous sinus, and interpeduncular fossa regions. The surgical results are summarized with a presentation of pre- and postoperative imaging from two illustrative cases. A detailed description of the operative procedure is provided with a comparison to other previously described surgical approaches.
Levy
M L
ML
Division of Neurosurgery, Children's Hospital of Los Angeles; Department of Neurosurgery, University of Southern California School of Medicine, Los Angeles, California.
Khoo
L T
LT
Day
J D
JD
Liker
M
M
McComb
J G
JG