title: Safe fronto-orbito-zygomatic osteotomy using a diamond-coated threadwire saw in orbito-zygomatic craniotomy.
abstract: Orbito-zygomatic craniotomy is a widely accepted skull-based technique, but osteotomy at the malar eminence (ME) is complicated. We have developed a safe fronto-orbito-zygomatic (FOZ) osteotomy by creating small guide burr holes in the superior and lateral parts of the orbital wall and cutting the bone using a diamond-coated threadwire saw. This method involves standard two-piece osteotomy by creating small superior and lateral guide orbital burr holes instead of sectioning into the superior and inferior orbital fissures. The guide burr holes are connected using a diamond-coated threadwire saw to create the FOZ bar. This method was applied to the treatment of four patients with skull-based tumors or internal carotid and basilar artery aneurysms. Postoperative three-dimensional bone density computed tomography showed minimum bone gap in the ME. No craniotomy-related complication has occurred. FOZ osteotomy by creating guide burr holes in the orbital wall and cutting the bone using a diamond-coated threadwire saw is safe and results in minimum bone gap in the ME.
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Wada
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mori
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Terushige
authors.initials: T
authors.lastname: Toyooka
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Otani
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ueno
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tomura
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Arata
authors.initials: A
authors.lastname: Tomiyama
keywords: Diamond-coated threadwire saw; orbital guide burr holes; orbito-zygomatic approach; skull-based surgery