Frontosupraorbital Approach and Orbitozygomatic Temporopolar Approach for High Basilar Aneurysms.

Rhee, Bong Arm; Yi, Jung Seok; Park, Jong Tae; Lim, Young Jin; Kim, Tae Sung; Leem, Won; Kim, Gook Ki

Original Article

Journal of Korean Neurosurgical Society 1999;28(2): 164-173.

Bong Arm Rhee, Jung Seok Yi, Jong Tae Park, Young Jin Lim, Tae Sung Kim, Won Leem, Gook Ki Kim

Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea.

ABSTRACT

Surgery of aneurysms around the basilar bifurcation artery is still one of the most difficult and challenging operations in the field of neurosurgery, because of their rare occurrences, unfamiliar anatomy and deeply located lesions. Two major surgical approaches, pterional approach and subtemporal approach, are conventionally used for upper basilar artery aneurysm. Neither approach, however, ensures easy treatment of high basilar bifurcation aneurysm, because there is always the chance of excessive retraction of the brain, nerves and vessels. In order to gain sufficient exposure of highly placed basilar bifurcation aneurysms, the surgical approach needs to be in the direction in which the surgeon can see the interpeduncular fossa from below. In an attempt to gain better exposure of these lesions, neurosurgeons have used a variety of surgical approaches. We have used forntosupraorbital(FSO) approach and orbitozygomatic temporopolar(OZTP) approach for seven cases of high basilar aneurysm including basilar bifurcation artery-SCA aneurysm. The advantage of these approaches are multidirectional view, wide operative field, less brain retraction and easy application of temporary clip. Therefore, authors would like to recommended these approaches in case of for high basilar aneurysm as a effective method of aneurysmal neck clipping.

Key Words: Frontosupraorbital approach; Orbitozygomatic temporopolar approach; High basilar bifurcation aneurysm; High basilar-SCA aneurysm