title: [Transzygomatic pterional approach. Part 1: anatomical study].
abstract: OBJECTIVE
  Cadaveric study of the anatomical structures of the temporal region, as well as the technical aspects of the transzygomatic pterional approach.
  
  
  METHODS
  Six human formalin-fixed heads, whose arterial circulatory system was injected with red-dyed silicone, were studied (12 temporal regions). Dissections were performed using standard microsurgical techniques and instruments.
  
  
  RESULTS
  We confirm the existence of a double superficial and deep layer within the superficial temporal fascia, which makes possible to perform the zygomatic arch osteotomy without damaging the temporal muscle and the branches of the superficial temporal artery and the facial nerve. The shape and location of the osteotomies to preserve the témporo-mandibular joint and ligaments and to provide correct reconstruction of the bone flap are described. We compare the exposure of intracranial structures obtained by this approach with those obtained by the conventional pterional approach and the orbitozygomatic approach.
  
  
  CONCLUSIONS
  The transzygomatic pterional approach provides wide exposure of the temporal lobe for trans-sylvian, pre-temporal and/or subtemporal approaches in selected cases of neurosurgical pathology. A detailed anatomical knowledge of the temporal region is necessary to achieve the best surgical, functional and cosmetic results.
authors.affiliation: Laboratorio de Anatomía Neuroquirúrgica, Servicio de Neurocirugía, Hospital Clínico Universitario, Valencia, España.
authors.forename: Vicent
authors.initials: V
authors.lastname: Quilis-Quesada
authors.forename: Laura
authors.initials: L
authors.lastname: Botella-Maciá
authors.forename: José M
authors.initials: JM
authors.lastname: González-Darder
mesh_terms: D002102:Cadaver; D003399:Craniotomy; D004210:Dissection; D005154:Facial Nerve; D006801:Humans