Combined orbito-frontal, sub- and infratemporal fossa approach to skull base neoplasms. Surgical technique and clinical application.

Abstract

Neoplasms located along the antero-lateral skull base, with probable involvement of the orbit and with extension into the pterygoid and/or infratemporal fossa can usually not be sufficiently exposed using standard neurosurgical or otosurgical approaches, which is why combined approaches to these skull base targets have been developed in the recent past. In this report we describe our experience, using a combined orbito-frontal, sub- and infratemporal fossa approach which, starting with a pre-auricular incision and a standard pterional craniotomy, is extended to an extensive osteoplastic enbloc resection of the orbito-zygomatic area allowing for direct visualisation of the antero-temporo-lateral skull base from the orbital cavity to the depth of the infratemporal and pterygoid fossa. The surgical technique as well as the clinical experiences accumulated with this approach are described.