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Published on: January 17, 2018
Modified orbitozygomatic craniotomy for large medial sphenoid wing meningiomas
Cheng-Mao Cheng1, Cheng-Fu Chang, Hsin-I Ma
1Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Summary
The modified orbitozygomatic craniotomy (MOZC) offers a safe and effective surgical approach for large sphenoid wing meningiomas. This technique allows for complete tumor resection with minimal neurological impact on patients.
Area of Science:
- Neurosurgery
- Skull Base Surgery
- Oncology
Background:
- The modified orbitozygomatic craniotomy (MOZC) is an anterior lateral skull base surgical approach known for its simplicity and broad operative exposure.
- Clinical reports on the MOZC approach, first introduced in 2003, remain limited.
- Large sphenoid wing meningiomas present a surgical challenge due to their size and location.
Purpose of the Study:
- To detail the treatment outcomes of patients with large (>4 cm) sphenoid wing meningiomas using the MOZC approach.
- To evaluate the feasibility and safety of the MOZC approach for managing complex skull base tumors.
- To present the first published English report on the MOZC approach for sphenoid wing meningiomas.
Main Methods:
- Retrospective case series of 5 patients with large sphenoid wing meningiomas treated with MOZC.
- Surgical technique emphasizes sparing the zygomatic arch and removing the orbital rim for enhanced surgical field.
- Tumor resection performed prior to dural opening to minimize brain retraction.
Main Results:
- Complete tumor resection was achieved in all 5 patients.
- One patient experienced a postoperative epidural hematoma, which was successfully managed.
- All patients resumed daily activities without any neurological deficits.
Conclusions:
- The modified orbitozygomatic craniotomy (MOZC) is a clinically viable surgical option for large sphenoid wing meningiomas and other paraclinoid lesions.
- The MOZC approach provides a capacious operative field, allowing for tumor resection with reduced brain retraction and low morbidity.
- This technique offers advantages in preserving facial structures while ensuring adequate surgical access for complex anterior lateral skull base tumors.
