터어키안 주위병변 수술을 위한 작은 전두안와 개두술

Abstract

To minimize brain injury from exposure and retraction and to achieve better cosmesis, in subfrontal approach for skull base lesions, a smaller and more basal opening is required. The technique and result of the frontoorbital minicraniotomy are presented. A frontoorbital minicraniotomy through a curvilinear frontotemporal skin incision was performed by removing parts of frontal bone, orbital roof, and orbital rim as a single piece. Extensive and deep lesions were handled via combined subfrontal and pterional routes during the same operation. This technique has been applied to seven patients who were operated on for different pathologies in the parasellar region. Subtotal removal of lesion was achieved in one patient with large craniopharyngioma. The lesions of other patients (two Rathke's cleft cysts, two meningiomas, one neurocysticercosis, one craniopharyngioma) were removed completely. There were no approachrelated complications. The major advantages of this approach are a short surgical route, a basal view with only minimal brain trauma, and a minimized amount of bone resection with excellent cosmetic results.