Orbitozygomatic Approaches to Skull Base Tumors

V.A. Cherekaev, A.Kh. Bekyashev, A.I. Belov, S.R. Arustamyan, A.G. Vinokurov, T.A. Abramov, T.G. Gasparyan, A.A. Imaev, V.V. Gromova

(Burdenko Research Institute of Neurosurgery, Moscow)

Different versions of an orbitozygomatic approach are used in basal surgery most frequently. The basis of this approach is forming a basal flap, including a zygomatic bone and adjacent segments of an orbital ring. A process spread conditions use of different versions of this approach, which differ in a method of the second flap formation, including adjacent segments of temporal and frontal squama. There are certain indications for additional resection of articular and coronoid processes of the lower jaw.

There were 215 cases, operated in the Burdenko Research Institute of Neurosurgery in 2000-2005. Orbitozygomatic approaches were performed in removal of 144 meningiomas, 10 neurinomas of the fifth nerve, 8 chordomas, 8 craniofacial juvenile angiofibromas, 7 neurofibromas and 38 different tumors. We used 10 approaches, depending on a process spread. Pyo-inflammatory complications were observed in 6 cases; 2 of them with giant skull base tumors died in a remote period (in 3-4 months).

The report contains information on technical peculiarities of orbitozygomatic approaches, clinical examples, complications and means of their prevention.