Subtemporal approach

Intra- and extradural approach, anterior petrosal approach, and endonasal approach

Research output: Contribution to journalArticle

Abstract

The subtemporal approach is applied to the middle cranial fossa and infratemporal fossa in addition to the tentorial incisura, petroclivus, and brain stem lesions. To minimize compression damage to the temporal lobe, it is essential to perform the craniotomy along the middle cranial fossa, to remove the zygomatic arch for supratentorial lesions, and to remove the petrous pyramid for infratentorial lesions. To avoid venous damage, the drainage pathways of the superficial sylvian vein and bridging veins, including Labbé’s vein, should be preoperatively evaluated. Furthermore, with the recent advances in endoscopic surgery, it has become possible to approach the middle cranial fossa and infratemporal fossa endonasally. In the endonasal approach, surgical simulation is important because of the variations in the nasal cavity and paranasal sinus structures. In this article, we outline the surgical anatomy of the middle cranial fossa required for the subtemporal approach, including the endonasal approach, and variations in the venous drainage of the superficial sylvian vein and petrosal vein. Moreover, we describe the treatment of pontine lesions by the subdural subtemporal approach, Meckel cave lesions by the epidural subtemporal approach, petroclival lesions by the anterior transpetrosal approach, and infratemporal lesions by the endonasal approach.

Original languageEnglish
Pages (from-to)818-827
Number of pages10
JournalJapanese Journal of Neurosurgery
Volume27
Issue number11
DOIs
Publication statusPublished - 2018 Jan 1

Fingerprint

Middle Cranial Fossa
Cerebral Veins
Veins
Paranasal Sinuses
Drainage
Petrous Bone
Zygoma
Craniotomy
Nasal Cavity
Temporal Lobe
Brain Stem
Anatomy

Keywords

  • Endoscopic
  • Infratemporal fossa
  • Meckel
  • Middle cranial fossa
  • Sylvian vein

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

@article{0d8c8320795849908caa8a0d709aa455,
title = "Subtemporal approach: Intra- and extradural approach, anterior petrosal approach, and endonasal approach",
abstract = "The subtemporal approach is applied to the middle cranial fossa and infratemporal fossa in addition to the tentorial incisura, petroclivus, and brain stem lesions. To minimize compression damage to the temporal lobe, it is essential to perform the craniotomy along the middle cranial fossa, to remove the zygomatic arch for supratentorial lesions, and to remove the petrous pyramid for infratentorial lesions. To avoid venous damage, the drainage pathways of the superficial sylvian vein and bridging veins, including Labb{\'e}’s vein, should be preoperatively evaluated. Furthermore, with the recent advances in endoscopic surgery, it has become possible to approach the middle cranial fossa and infratemporal fossa endonasally. In the endonasal approach, surgical simulation is important because of the variations in the nasal cavity and paranasal sinus structures. In this article, we outline the surgical anatomy of the middle cranial fossa required for the subtemporal approach, including the endonasal approach, and variations in the venous drainage of the superficial sylvian vein and petrosal vein. Moreover, we describe the treatment of pontine lesions by the subdural subtemporal approach, Meckel cave lesions by the epidural subtemporal approach, petroclival lesions by the anterior transpetrosal approach, and infratemporal lesions by the endonasal approach.",
keywords = "Endoscopic, Infratemporal fossa, Meckel, Middle cranial fossa, Sylvian vein",
author = "Masahiro Toda and Kazunari Yoshida",
year = "2018",
month = "1",
day = "1",
doi = "10.7887/jcns.27.818",
language = "English",
volume = "27",
pages = "818--827",
journal = "Japanese Journal of Neurosurgery",
issn = "0917-950X",
publisher = "Japanese Congress of Neurological Surgeons",
number = "11",

}

TY - JOUR

T1 - Subtemporal approach

T2 - Intra- and extradural approach, anterior petrosal approach, and endonasal approach

AU - Toda, Masahiro

AU - Yoshida, Kazunari

PY - 2018/1/1

Y1 - 2018/1/1

N2 - The subtemporal approach is applied to the middle cranial fossa and infratemporal fossa in addition to the tentorial incisura, petroclivus, and brain stem lesions. To minimize compression damage to the temporal lobe, it is essential to perform the craniotomy along the middle cranial fossa, to remove the zygomatic arch for supratentorial lesions, and to remove the petrous pyramid for infratentorial lesions. To avoid venous damage, the drainage pathways of the superficial sylvian vein and bridging veins, including Labbé’s vein, should be preoperatively evaluated. Furthermore, with the recent advances in endoscopic surgery, it has become possible to approach the middle cranial fossa and infratemporal fossa endonasally. In the endonasal approach, surgical simulation is important because of the variations in the nasal cavity and paranasal sinus structures. In this article, we outline the surgical anatomy of the middle cranial fossa required for the subtemporal approach, including the endonasal approach, and variations in the venous drainage of the superficial sylvian vein and petrosal vein. Moreover, we describe the treatment of pontine lesions by the subdural subtemporal approach, Meckel cave lesions by the epidural subtemporal approach, petroclival lesions by the anterior transpetrosal approach, and infratemporal lesions by the endonasal approach.

AB - The subtemporal approach is applied to the middle cranial fossa and infratemporal fossa in addition to the tentorial incisura, petroclivus, and brain stem lesions. To minimize compression damage to the temporal lobe, it is essential to perform the craniotomy along the middle cranial fossa, to remove the zygomatic arch for supratentorial lesions, and to remove the petrous pyramid for infratentorial lesions. To avoid venous damage, the drainage pathways of the superficial sylvian vein and bridging veins, including Labbé’s vein, should be preoperatively evaluated. Furthermore, with the recent advances in endoscopic surgery, it has become possible to approach the middle cranial fossa and infratemporal fossa endonasally. In the endonasal approach, surgical simulation is important because of the variations in the nasal cavity and paranasal sinus structures. In this article, we outline the surgical anatomy of the middle cranial fossa required for the subtemporal approach, including the endonasal approach, and variations in the venous drainage of the superficial sylvian vein and petrosal vein. Moreover, we describe the treatment of pontine lesions by the subdural subtemporal approach, Meckel cave lesions by the epidural subtemporal approach, petroclival lesions by the anterior transpetrosal approach, and infratemporal lesions by the endonasal approach.

KW - Endoscopic

KW - Infratemporal fossa

KW - Meckel

KW - Middle cranial fossa

KW - Sylvian vein

UR - http://www.scopus.com/inward/record.url?scp=85059263365&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059263365&partnerID=8YFLogxK

U2 - 10.7887/jcns.27.818

DO - 10.7887/jcns.27.818

M3 - Article

VL - 27

SP - 818

EP - 827

JO - Japanese Journal of Neurosurgery

JF - Japanese Journal of Neurosurgery

SN - 0917-950X

IS - 11

ER -