Kim Jin Gu, Lee Dong Hoon, Kim Young Il, Kim Il Sup, Sung Jae Hoon, Yang Seung Ho
Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Brain Tumor Res Treat. 2021 Oct;9(2):58-62. doi: 10.14791/btrt.2021.9.e24.
Modified orbitozygomatic craniotomy is characterized by simplicity and wide exposure. The purpose of the present study was to describe a modified orbitozygomatic approach without resecting the zygomatic arch for large parasellar tumor surgeries.
Between April 2016 and December 2019, seven patients with parasellar tumor underwent surgiest with a modified orbitozygomatic approach. Surgical procedures, clinical outcomes, and complications were analyzed.
This study included 3 meningiomas, 2 pituitary adenomas, 1 chondrosarcoma, and 1 schwannoma. Modified orbitozygomatic craniotomy provides a wider surgical freedom in the opticocarotid and prechiasmatic cistern than frontotemporal craniotomy without orbitotomy, Total, subtotal, and partial resections were achieved for 3, 2, and 2 patients, respectively. Reasons for partial resections were tight adhesion to the carotid artery and encasing of the carotid artery. Permanent morbidities developed in one patient with 3rd nerve palsy and one patient with hemiparesis.
Modified orbitozygomatic approach can provide the shortest access to the interpeduncular cistern with a minimum brain retraction. Surgeons who experience surgical challenge during the conventional approach for parasellar tumor resection are recommended to learn the modified orbitozygomatic approach.
改良眶颧开颅术具有操作简单、暴露范围广的特点。本研究的目的是描述一种不切除颧弓的改良眶颧入路，用于大型鞍旁肿瘤手术。
2016年4月至2019年12月，7例鞍旁肿瘤患者接受了改良眶颧入路手术。分析手术过程、临床结果和并发症。
本研究包括3例脑膜瘤、2例垂体腺瘤、1例软骨肉瘤和1例神经鞘瘤。与不进行眶切开的额颞开颅术相比，改良眶颧开颅术在视交叉池和视交叉前池提供了更广泛的手术操作空间。分别有3例、2例和2例患者实现了全切除、次全切除和部分切除。部分切除的原因是与颈动脉紧密粘连和颈动脉包绕。1例患者出现动眼神经麻痹，1例患者出现偏瘫，发生了永久性神经功能障碍。
改良眶颧入路可以以最小的脑牵拉提供到达脚间池的最短路径。对于在传统鞍旁肿瘤切除手术中遇到手术挑战的外科医生，建议学习改良眶颧入路。
