Balasingam Vijayabalan, Noguchi Akio, McMenomey Sean O, Delashaw Johnny B
Division of Skull Base Neurosurgery, Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA.
J Neurosurg. 2005 May;102(5):940-4. doi: 10.3171/jns.2005.102.5.0940.
The authors report on a surgical technique involving a one-piece osteoplastic bone flap, which incorporates the frontal, temporal, and lateral portions of the orbital rim as a technically simpler alternative to the standard orbitozygomatic (OZ) craniotomy. The orbital rim component extends just laterally from the supraorbital foramen/notch to the frontozygomatic suture. This craniotomy obviates the need for removing the zygoma and has evolved from the authors' experience in more than 200 patients with a variety of pathological lesions, both vascular and tumorous. The osteoplastic aspect of this technique was initially evaluated in 14 cadaveric sites in seven heads dissected prior to implementing this procedure clinically. The osteoplastic bone flap minimally obstructs the surgical view and provides all the advantages of a standard OZ craniotomy. Temporalis muscle atrophy leading to temporal hollowing is avoided, a bone union to the calvaria is improved, and the possibility of bone infection is decreased. The osteoplastic component of the technique adds to the improved long-term cosmesis and warrants active consideration in the art of neurosurgery.
作者报告了一种手术技术，该技术涉及一块一体式骨成形骨瓣，它包含眶缘的额部、颞部和外侧部分，作为标准眶颧（OZ）开颅术在技术上更简单的替代方法。眶缘部分从眶上孔/切迹向外侧延伸至额颧缝。这种开颅术无需切除颧骨，它是作者在200多名患有各种血管性和肿瘤性病理病变的患者中的经验演变而来。在临床实施该手术之前，先在七个头部的14个尸体部位对该技术的骨成形方面进行了评估。骨成形骨瓣对手术视野的阻碍最小，并具备标准OZ开颅术的所有优点。可避免颞肌萎缩导致的颞部凹陷，改善颅骨与颅骨的骨愈合，并降低骨感染的可能性。该技术的骨成形部分有助于改善长期美观效果，值得神经外科领域积极考虑。
