title: The transzygomatic approach.
abstract: We aim to describe the technical details of the transzygomatic approach to intracranial surgery. The incision begins at the level of the inferior border of the zygomatic arch, anterior to the tragus, and extends towards the contralateral pupillary line. A subgaleal and interfascial dissection is performed. Then, the zygomatic arch is vertically sectioned twice and mobilized downwards, together with the masseter muscle. Next, a fronto-temporo-sphenoidal craniotomy is performed and complete exposure of the anterior temporal dura achieved. Thus, the surgical possibilities are: (i) intradural access to the middle fossa; (ii) intradural pretemporal access to the basal cisterns; (iii) intradural transtemporal access to the insular region; and (iv) extradural access to the middle fossa. The transzygomatic approach offers excellent exposure to the floor of the middle fossa and the lateral wall of the cavernous sinus (both intradurally and extradurally). Also, combined with a pretemporal approach, it affords a good view of the interpeduncular cistern; and using a transtemporal approach, it provides good access to the insular region.
authors.affiliation: Department of Anatomy, School of Medicine, University of Tucumán, Ayacucho 491, San Miguel de Tucumán, Tucumán 4000, Argentina. alvarocampero@yahoo.com.ar
authors.forename: Alvaro
authors.initials: A
authors.lastname: Campero
authors.forename: A Agustín
authors.initials: AA
authors.lastname: Campero
authors.forename: Mariano
authors.initials: M
authors.lastname: Socolovsky
authors.forename: Carolina
authors.initials: C
authors.lastname: Martins
authors.forename: Alexandre
authors.initials: A
authors.lastname: Yasuda
authors.forename: Armando
authors.initials: A
authors.lastname: Basso
authors.forename: Albert
authors.initials: A
authors.lastname: Rhoton
mesh_terms: D035301:Cranial Fossa, Middle / Q000033:anatomy & histology / Q000601:surgery*; D003399:Craniotomy / Q000379:methods* / Q000639:trends; D006801:Humans; D012886:Skull / Q000033:anatomy & histology / Q000601:surgery*; D019291:Skull Base / Q000033:anatomy & histology / Q000601:surgery*; D016896:Treatment Outcome; D015050:Zygoma / Q000033:anatomy & histology / Q000601:surgery*