Anatomic And Clinical Study Of The Mini-orbitozygomatic Approach

Objective: To evaluate the surgical exposure of themini-orbitozygomatic approach on the basis of the quantification in acadaveric study and to review the application of the mini-orbitozygomaticapproach on7patients.Methods: In an anatomic study, five cadaveric heads underwentpterional approach (PT), mini-orbitozygomatic approach (MOZ) andfrontotemporal-orbitozygomatic approach (FTOZ) serially on ten sides.Then we quantified the angles of exposure of these three approachesrespectively without brain retraction. The paired t test was used todetermine significant average difference in angle measurement amongthree approaches at each target site.In a clinical study,7patients who underwent the mini-orbitozygomatiapproaches were evaluated for the surgical exposure and thepostoperative complications.Results: The mean angles of exposure in the anteriorcommunicating artery (ACoA), the anterior clinoid process (ACP), theinternal carotid bifurcation (ICB), the posterior clinoid process (ACP), and the basilar artery top (BT) in the MOZ increased by213%,35%,37%,37%, and93%more than those in the PT respectively. There was nosignificant difference between the angles of exposure in the ACP, the ICB,the ACP, and the BT in the MOZ and those in the FTOZ. The meanangles of exposure in the ACoA and the middle cerebral artery bifurcation(MCB) in the MOZ decreased by20%and34%less than those in theFTOZ respectively.Clinically, there were satisfied exposures when usingthe MOZ to deal with basicranial lesions of7patients without brainretractor. There were no serious complications postoperation.Conclusion: The MOZ was better than the PT on the aspect ofexposure the deeply basicranial tissue, and was similar to the FTOZ onthat. The MOZ seemed to decrease the risk of intraoperative braindamage.