Zygomatic approach for resection of mesial temporal epileptic focus

By using the zygomatic approach, temporal mesial and polar epileptic foci are easily accessible through an incision in the inferior temporal gyrus. In this approach, a major part of the superior and middle temporal gyrus is preserved, and there is no risk of postoperative dysnomia even on the dominant side for speech. Combined use of depth and subdural electrodes is advisable for precise determination of focus distributions throughout the mesial and lateral structures of the temporal lobe. We have applied this approach in 5 patients with satisfactory results.