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Modified osteoplastic orbitozygomatic craniotomy in the pediatric population. Childs Nerv Syst 2008 Jul;24(7):845-50 PMID: 18236050

Pubmed ID

18236050

DOI

10.1007/s00381-007-0575-3

Abstract

OBJECT: Anterior and anterolateral skull base approaches offer the advantages of improved visualization and minimal brain retraction for lesions involving the orbital apex, parasellar regions, and anterior and middle fossa floors. These approaches are seldom used in the pediatric population due to the perceived increase in morbidity and surgical complexity. We report the application of the previously described modified osteoplastic orbitozygomatic (OZ) craniotomy to pediatric neurosurgical cases. This approach offers a number of advantages and is technically straightforward.

MATERIALS AND METHODS: The results from six pediatric cases are reported. Age ranged from 26 months to 15 years, with a follow-up period of 5 to 22 months. Pathology included craniopharyngioma (three), frontal epidural abscess-subdural empyema with intraorbital extension (one), hypothalamic hamartoma (one), and optic pathway glioma (one). No complications related to the surgical approach were noted. In all cases, good postoperative cosmesis was achieved with excellent realignment of the orbital rim. Temporalis muscle bulk was preserved and symmetric in all cases.

CONCLUSION: The modified osteoplastic OZ craniotomy can be safely and effectively applied to the pediatric population. Advantages include: (1) ease of use; (2) superior exposure and therefore less brain retraction; (3) an easily replaced one-piece bone flap which obviates the need for plating-suturing at the orbital rim; (4) a vascularized bone flap less susceptible to infection; and (5) maintenance of normal temporalis muscle anatomy for improved cosmesis and function.

Author List

Miller ML, Kaufman BA, Lew SM

Authors

Bruce A. Kaufman MD Professor in the Neurosurgery department at Medical College of Wisconsin
Sean Lew MD Chief, Professor in the Neurosurgery department at Medical College of Wisconsin




Scopus

2-s2.0-44649190696   13 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Brain Diseases
Child
Child, Preschool
Craniotomy
Female
Follow-Up Studies
Humans
Male
Orbit
Osteogenesis
Surgical Flaps
Treatment Outcome
Zygoma
jenkins-FCD Prod-336 69ef4a6b262d135130251597d5d39873903802b5