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anterolateral_transcranial_approach

Anterolateral Transcranial Approach

The anterolateral transcranial approaches expose the suprasellar region via an anterolateral trajectory, usually through a transsylvian or unilateral subfrontal corridor. These generally include the pterional (frontotemporal), orbitozygomatic, and lateral supraorbital (frontolateral) approaches.

While all of these approaches typically use a curvilinear incision behind the hairline, the latter group of supraorbital approaches can also be performed with smaller eyebrow or eyelid incisions.

These are familiar approaches that provide a short route to the suprasellar region and are particularly useful for tumors that exhibit lateral extension into the sylvian fissure. Recently, Gerganov et al. reported excellent outcomes with an 87% rate of gross-total resection of extensive craniopharyngiomas using a more simple frontolateral craniotomy. While there are a variety of anterolateral approaches, we prefer the one-piece modified orbitozygomatic approach. This approach is a natural extension of the pterional approach which provides a more basal (inferior-to-superior) surgical trajectory, increases the corridor of exposure, shortens the distance to the target, and improves surgical freedom (maneuverability of instruments) while minimizing brain retraction 1).

1)
Liu JK, Sevak IA, Carmel PW, Eloy JA. Microscopic versus endoscopic approaches for craniopharyngiomas: choosing the optimal surgical corridor for maximizing extent of resection and complication avoidance using a personalized, tailored approach. Neurosurg Focus. 2016 Dec;41(6):E5. PubMed PMID: 27903113.
anterolateral_transcranial_approach.txt · Last modified: 2016/12/05 23:12 (external edit)