Management of complex brain lesions arising at sellar, petroclival, and interpeduncular regions via the pretemporal approach: Technical note
Background: Lesions of sellar, interpeduncular, and petroclival regions represent surgical challenges due to the spatial limitations imposed by the temporal lobe. The pretemporal approach is rarely advocated for this kind of lesions even when it offers a wider operative field than other traditional...
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doaj-38d9b44c5ff9444ea35bc9b3972801982021-07-17T04:34:21ZengElsevierInterdisciplinary Neurosurgery2214-75192021-09-0125101247Management of complex brain lesions arising at sellar, petroclival, and interpeduncular regions via the pretemporal approach: Technical noteParménides Guadarrama-Ortiz0José Alberto Choreño-Parra1André Garibay-Gracián2Ingrid Montes de Oca-Vargas3César Osvaldo Ruíz-Rivero4Deyanira Capi-Casillas5Arturo Samuel Alpízar-Acevedo6Ángel Daniel Prieto-Rivera7Carlos Castillo-Rangel8Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Mexico City, Mexico; Corresponding author.Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Mexico City, MexicoServicio Social en Investigación, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Mexico City, Mexico; Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City, MexicoServicio Social en Investigación, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Mexico City, Mexico; Facultad de Estudios Superiores (FES) Iztacala, Universidad Nacional Autónoma de México (UNAM), Tlalnepantla de Baz, MexicoDepartment of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Mexico City, MexicoInternado Médico de Pregrado, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Mexico City, MexicoInternado Médico de Pregrado, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Mexico City, MexicoDepartment of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Mexico City, MexicoServicio de Neurocirugía, Hospital Regional 1° de Octubre, ISSSTE, Mexico City, MexicoBackground: Lesions of sellar, interpeduncular, and petroclival regions represent surgical challenges due to the spatial limitations imposed by the temporal lobe. The pretemporal approach is rarely advocated for this kind of lesions even when it offers a wider operative field than other traditional techniques. Case presentation: Here, we share our experience with the use of the pretemporal approach in a small case series: a giant meningioma of the tentorial notch (case 1), an aneurysm of the left posterior cerebral artery (case 2), and a giant pituitary adenoma (case 3). A frontotemporal incision was made with patients in supine position, their heads turned to the opposite side, and the malar eminence as their upper point. The skin flap and the temporal muscle were retracted anteriorly and inferiorly, respectively. The frontotemporosphenoidal craniotomy was performed and the lesser sphenoid wing removed. For cases 2 and 3, an orbitozygomatic craniotomy was added. After an S-shaped dura matter opening, the access to the interpeduncular fossa was through the sylvian fissure by careful dissection of adhesions between frontal and temporal lobes. Conclusions: On experienced hands, the pretemporal approach is a safe procedure for the management of lesions located in deep brain areas with low postoperative morbidity.http://www.sciencedirect.com/science/article/pii/S2214751921001596Pretemporal approachMeningiomaCerebral aneurysmsNeurosurgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Parménides Guadarrama-Ortiz José Alberto Choreño-Parra André Garibay-Gracián Ingrid Montes de Oca-Vargas César Osvaldo Ruíz-Rivero Deyanira Capi-Casillas Arturo Samuel Alpízar-Acevedo Ángel Daniel Prieto-Rivera Carlos Castillo-Rangel |
spellingShingle |
Parménides Guadarrama-Ortiz José Alberto Choreño-Parra André Garibay-Gracián Ingrid Montes de Oca-Vargas César Osvaldo Ruíz-Rivero Deyanira Capi-Casillas Arturo Samuel Alpízar-Acevedo Ángel Daniel Prieto-Rivera Carlos Castillo-Rangel Management of complex brain lesions arising at sellar, petroclival, and interpeduncular regions via the pretemporal approach: Technical note Interdisciplinary Neurosurgery Pretemporal approach Meningioma Cerebral aneurysms Neurosurgery |
author_facet |
Parménides Guadarrama-Ortiz José Alberto Choreño-Parra André Garibay-Gracián Ingrid Montes de Oca-Vargas César Osvaldo Ruíz-Rivero Deyanira Capi-Casillas Arturo Samuel Alpízar-Acevedo Ángel Daniel Prieto-Rivera Carlos Castillo-Rangel |
author_sort |
Parménides Guadarrama-Ortiz |
title |
Management of complex brain lesions arising at sellar, petroclival, and interpeduncular regions via the pretemporal approach: Technical note |
title_short |
Management of complex brain lesions arising at sellar, petroclival, and interpeduncular regions via the pretemporal approach: Technical note |
title_full |
Management of complex brain lesions arising at sellar, petroclival, and interpeduncular regions via the pretemporal approach: Technical note |
title_fullStr |
Management of complex brain lesions arising at sellar, petroclival, and interpeduncular regions via the pretemporal approach: Technical note |
title_full_unstemmed |
Management of complex brain lesions arising at sellar, petroclival, and interpeduncular regions via the pretemporal approach: Technical note |
title_sort |
management of complex brain lesions arising at sellar, petroclival, and interpeduncular regions via the pretemporal approach: technical note |
publisher |
Elsevier |
series |
Interdisciplinary Neurosurgery |
issn |
2214-7519 |
publishDate |
2021-09-01 |
description |
Background: Lesions of sellar, interpeduncular, and petroclival regions represent surgical challenges due to the spatial limitations imposed by the temporal lobe. The pretemporal approach is rarely advocated for this kind of lesions even when it offers a wider operative field than other traditional techniques. Case presentation: Here, we share our experience with the use of the pretemporal approach in a small case series: a giant meningioma of the tentorial notch (case 1), an aneurysm of the left posterior cerebral artery (case 2), and a giant pituitary adenoma (case 3). A frontotemporal incision was made with patients in supine position, their heads turned to the opposite side, and the malar eminence as their upper point. The skin flap and the temporal muscle were retracted anteriorly and inferiorly, respectively. The frontotemporosphenoidal craniotomy was performed and the lesser sphenoid wing removed. For cases 2 and 3, an orbitozygomatic craniotomy was added. After an S-shaped dura matter opening, the access to the interpeduncular fossa was through the sylvian fissure by careful dissection of adhesions between frontal and temporal lobes. Conclusions: On experienced hands, the pretemporal approach is a safe procedure for the management of lesions located in deep brain areas with low postoperative morbidity. |
topic |
Pretemporal approach Meningioma Cerebral aneurysms Neurosurgery |
url |
http://www.sciencedirect.com/science/article/pii/S2214751921001596 |
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