Orbitozygomatic infratemporal approach to lateral skull base tumors

An orbitozygomatic infratemporal approach for the removal of large neoplasms involving the lateral skull base is described. This approach, involves a unilateral frontotemporal incision extended inferiorly to the neck, a lateral facial flap reflected anteriorly. Transection of the zygoma is followed by its reflection inferolaterally with the temporalis muscle. This exposure provides excellent visualization of both the intradural and extradural aspects of the anterior portion of the cavernous sinus, allowing an aggressive resection of neoplasms in this region. Experience with this procedure in the management of 15 patients is reported here. There was one postoperative death due to pneumonia and septicemia. The morbidities included wound infection, meningitis, CSF leakage and cranial nerve palsy. All the surviving patients, are living independently and have returned to their previous occupations.