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Technical note: Orbitozygomatic craniotomy using an ultrasonic osteotome for precise osteotomies.

Jacob Ruzevick1, Shaan M Raza2, Pablo F Recinos1

  • 1Departments of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, USA.

Clinical Neurology and Neurosurgery
|May 4, 2015
PubMed
Summary

An ultrasonic osteotome offers a safe and precise method for creating orbitozygomatic osteotomies during neurosurgery. This technique minimizes risks to critical structures, proving effective in skull base tumor resections.

Keywords:
CraniotomeOrbitozygomatic approachUltrasonic osteotome

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Area of Science:

  • Neurosurgery
  • Skull Base Surgery
  • Surgical Technology

Background:

  • Orbitozygomatic craniotomy is essential for accessing orbital and skull base pathologies.
  • Accurate osteotomies are critical for successful surgical outcomes.

Purpose of the Study:

  • To evaluate the safety and feasibility of using an ultrasonic osteotome for orbitozygomatic osteotomies.
  • To assess the instrument's efficacy in patients with intracranial pathology.

Main Methods:

  • Retrospective review of six patients undergoing orbitozygomatic craniotomy with an ultrasonic osteotome (Aesculap BoneScalpel™).
  • Procedures were performed for tumor resection at Johns Hopkins Hospital (Nov 2009 - Mar 2013).

Main Results:

  • No instances of periorbital violation, orbital injury, enophthalmos, or orbital hematoma were reported.
  • Two patients experienced transient diplopia; post-operative imaging showed well-opposed cuts and no cosmetic defects.
  • The average follow-up period was 375 days for the six female patients (average age 53.2).

Conclusions:

  • Ultrasonic osteotomes enable precise cuts with direct visualization during two-piece orbitozygomatic craniotomies.
  • This technology presents a low-risk option for osteotomy creation in skull base surgery.
  • The instrument demonstrated safety and efficacy in the studied cohort.