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The frontotemporal-orbitozygomatic approach : reconstructive technique and outcome

Youssef, A. Samy, Willard, Laura, Downes, Angela, Olivera, Raul, Hall, Kathryn, Agazzi, Siviero and van, Loveren Harry 2012, The frontotemporal-orbitozygomatic approach : reconstructive technique and outcome, Acta neurochirurgica, vol. 154, no. 7, pp. 1275-1282, doi: 10.1007/s00701-012-1370-9.

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Title The frontotemporal-orbitozygomatic approach : reconstructive technique and outcome
Author(s) Youssef, A. Samy
Willard, Laura
Downes, Angela
Olivera, Raul
Hall, KathrynORCID iD for Hall, Kathryn orcid.org/0000-0001-8648-0313
Agazzi, Siviero
van, Loveren Harry
Journal name Acta neurochirurgica
Volume number 154
Issue number 7
Start page 1275
End page 1282
Total pages 8
Publisher Springer
Place of publication Berlin, Germany
Publication date 2012
ISSN 0001-6268
0942-0940
Keyword(s) frontotemporal-orbitozygomatic approach
orbitopterional
pseudomeningocele
enophthalmos
exophthalmos
osteotomy
Summary Background The frontotemporal-orbitozygomatic (FTOZ) approach, also known as "the workhorse of skull base surgery," has captured the interest of many researchers throughout the years. Most of the studies published have focused on the surgical technique and the gained exposure. However, few studies have described reconstructive techniques or functional and cosmetic outcomes. The goal of this study was to describe the surgical reconstruction after the FTOZ approach and analyze the functional and cosmetic outcomes. Methods Seventy-five consecutive patients who had undergone FTOZ craniotomy for different reasons were selected. The same surgical (one-piece FTOZ) and reconstructive techniques were applied in all patients. The functional outcome was measured by complications related to the surgical approach: retro-orbital pain, exophthalmos, enophthalmos, ocular movement restriction, cranial nerve injuries, pseudomeningocele (PMC) and secondary surgeries required to attain a reconstructive closure. The cosmetic outcome was evaluated by analyzing the satisfaction of the patients and their families. Questionnaires were conducted later in the postoperative period. A statistical analysis of the data obtained from the charts and questions was performed. Results Of the 75 patients studied, 59 had no complications whatsoever. Ocular movement restriction was found in two patients (2.4 %). Cranial nerve injury was documented in seven patients (8.5 %). One patient (1.2 %) underwent surgical repair of a cerebrospinal fluid (CSF) leak from the initial surgery. Two patients (2.4 %) developed delayed postoperative pseudomenigocele. One patient (1.2 %) developed intraparenchymal hemorrhage (IPH). Full responses to the questionnaires were collected from 28 patients giving an overall response rate of 34 %. Overall, 22 patients (78.5 %) were satisfied with the cosmetic outcome of surgery. Conclusion The reconstruction after FTOZ approach is as important as the performance of the surgical technique. Attention to anatomical details and the stepwise reconstruction are a prerequisite to the successful preservation of function and cosmesis. In our series, the orbitozygomatic osteotomy did not increase surgical complications or alter cosmetic outcomes.
Notes Poster Presentation at The Frontotemporal-Orbitozygomatic Approach: Reconstructive technique and Outcome: Congress of Neurological Surgeons Annual Meeting, San Francisco, CA, October 2010
Language eng
DOI 10.1007/s00701-012-1370-9
Field of Research 179999 Psychology and Cognitive Sciences not elsewhere classified
Socio Economic Objective 970117 Expanding Knowledge in Psychology and Cognitive Sciences
HERDC Research category C2.1 Other contribution to refereed journal
Persistent URL http://hdl.handle.net/10536/DRO/DU:30052332

Document type: Journal Article
Collection: School of Psychology
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