| Objective: To compare the surgical exposure of subtemporal keyhole approach with that of traditional subtemporal approaches with or without zygomatic arch removal, and explore their clinical indications.Methods: 1.Eight adult cadaveric heads fixed with formalin were used in this study. Thin scannig of each head was performed preoperatively, and the image data were input into the neuronavigation system. Then the operation plan were made. 2.Subtemporal keyhole approach, traditional subtemporal approach without and with mobilization of zygomatic arch were performed in succession on each head, and the surgical exposure was observed under microscope. 3.During the surgical procedures, the neuronavigation system was used to guide the operations and to measure the maximal exposure lengths of tentorial margin, posterior cerebral artery, basilar artery and anterior border of brain stem, vertical distances between highest strudture in the field of view and posterior clinoid process, and surgical exposure areas. Data were analyzed statistically.Results: 1.Anterior and posterior clinoid process, supraclinoid segment of carotid artery and its main branches, oculomotor nerve, posterior portion of optic chiasma, superior portion of pituitary stalk, mammary bodies, distal segment of basilar artery, superior cerebellar artery, P1-P2 segment of posterior cerebral artery, ventrolateral surface of mesencephalon and pon higher than root of trigeminal nerve, and trochlear nerve in all heads could be observed via subtemporal keyhole approach and traditional transzygomatic subtemporal approach. Lower structures such as supraclinoid segment of carotid artery, oculomotor nerve, pons in all heads could be seen via subtemporal approach without zygomatic arch removal, but higher structures such as hypothalamus, mesencephalon in two heads, and high basilar bifurcation and P1 segment of posterior cerebral artery in one head, could not be seen owing to obstacle of view by temporalis...
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