The temporo-polar approach to basilar artery aneurysms with or without zygomatic arch translocation

Since the publication of the temporo-polar approach to basilar artery aneurysms by Sano (1980 and 1987), various modifications of the approach were reported. The approach provides a better view and a wider operating field than the subtemporal or pterional ones. Usually the approach does not need temporary remove of the zygomatic arch. If however, a basilar tip aneurysm is located very high above the posterior clinoid, temporary removal of the zygomatic arch is necessary which is sutured back to its original position at the end of the operation.