Zygomatic Anterior Temporal Approach for High-position Upper Basilar Aneurysm

Area of Science:

• Neurosurgery
• Vascular Surgery
• Surgical Neurology

Background:

• Skull base surgery for high-position upper basilar artery aneurysms often relies on specific surgical corridors.
• Traditional approaches like orbitozygomatic and subtemporal osteotomies create necessary surgical access.
• The anterior temporal approach's utility, particularly its middle surgical corridor, requires further elucidation.

Observation:

• This study details the zygomatic anterior temporal approach for high-position upper basilar artery aneurysms.
• Fourteen patients underwent this procedure between 2007 and 2018.
• Four patients required additional techniques to achieve adequate retro-carotid space.

Findings:

• The zygomatic anterior temporal approach successfully created a wide retro-carotid space for complete aneurysm ligation.
• Complete clip ligation of aneurysms was achieved in all patients without major surgical complications.
• This approach enables safe ligation without the need for orbitozygomatic osteotomy.

Implications:

• The zygomatic anterior temporal approach is a viable option for treating high-position upper basilar artery aneurysms.
• Surgeons should consider additional orbitozygomatic osteotomy if orbital or carotid artery structures impede surgical access.
• This technique offers an alternative corridor, potentially reducing operative morbidity.