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Updated: Mar 25, 2026
Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection
Published on: August 15, 2025
Frontotemporal-orbitozygomatic approach for pediatric cranio-orbital tumors: a single-center experience
Yafei Wang1, Yufan Chen1, Jia Wei1
1Department of Pediatric Neurosurgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
Objective:
To evaluate the surgical anatomy, technical nuances, and early postoperative outcomes of the frontotemporal-orbitozygomatic (FTOZ) approach in a consecutive series of pediatric cranio-orbital communicating tumors. To evaluate the surgical anatomy, technical nuances, and early postoperative outcomes of the frontotemporal-orbitozygomatic (FTOZ) approach in a consecutive series of pediatric cranio-orbital communicating tumors. Unilateral Dodge Class I Optic Pathway Glioma without Neurofibromatosis Type 1 (OPG-uDCI) was selected as an index pathology to illustrate the specific application of this approach in a representative subgroup.
Methods:
Thirteen children (five female, eight male) with imaging and histopathology confirmed cranio-orbital communicating tumours were managed at a single institution from April 2020 to August 2024.
Results:
At operation, the median age was 24 months (interquartile range 4-156 months). Postoperative surveillance extended for a median of 21 months (interquartile range 9-62 months). Notably, 10 patients had a follow-up period of at least 12 months. Histopathological diagnoses included: OPG, rhabdomyosarcoma, mature teratoma, optic nerve sheath meningioma, langerhans cell histiocytosis, and ewing-like sarcoma. Surgical complications included one case of severe postoperative chemosis with corneal ulceration requiring enucleation and one wound infection. There were no operative mortalities in this series. During follow-up, no patients with OPG demonstrated contralateral visual field changes postoperatively. Among the seven participants in whom macroscopic total excision was accomplished, neoplastic relapse subsequently developed in three.
Conclusions:
The FTOZ approach is a technically feasible corridor for resection of pediatric cranio-orbital tumors in selected cases. However, given the small sample size, short follow-up, and occurrence of major complications, these findings should be considered preliminary. Definitive conclusions regarding safety and efficacy await larger comparative studies.
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