Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA.
Neurosurgery. 2012 Aug;71(2):481-91; discussion 491-2. doi: 10.1227/NEU.0b013e318256c25a.
The frontotemporal, so-called pterional, approach has evolved with the contribution of many neurosurgeons over the past century. It has stood the test of time and has been the most commonly used transcranial approach in neurosurgery. In its current form, drilling the sphenoid wing as far down as the superior orbital fissure with or without the removal of the anterior clinoid, thinning the orbital roof, and opening the Sylvian fissure and basal cisterns are the hallmarks of this approach. Tumoral and vascular lesions involving the sellar/parasellar area, anterior and anterolateral circle of Willis, middle cerebral artery, anterior brainstem, upper basilar artery, insula, basal ganglia, mesial temporal region, anterior cranial fossa, orbit, and optic nerve are within the reach of the frontotemporal approach. In this article, we review the origins, evolution, and modifications of the frontotemporal approach and update the discussion of some of the related derivative procedures.
额颞部，也称为翼点入路，在过去一个世纪以来，随着许多神经外科医生的贡献而不断发展。它经受住了时间的考验，一直是神经外科最常用的颅外入路。目前，这种入路的特点是磨除蝶骨翼，尽可能向下磨到眶上裂，可联合或不联合切除前床突，磨薄眶顶，打开外侧裂和基底池。鞍区/鞍旁、前循环 Willis 环的前部和前外侧、大脑中动脉、前脑干、基底动脉上段、脑岛、基底节、内侧颞叶、前颅窝、眼眶和视神经等部位的肿瘤和血管病变都可以通过额颞部入路进行治疗。本文回顾了额颞部入路的起源、发展和改良，并更新了一些相关衍生手术的讨论。
