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Micko A, Minchev G, Wurzer A, Kronreif G, Wolfsberger S. A Patient-Specific Reference Tracker for Noninvasive Electromagnetic Navigation of Endoscopic Skull Base Surgery. Oper Neurosurg (Hagerstown) 2022; 23:499-504. [DOI: 10.1227/ons.0000000000000383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/05/2022] [Indexed: 11/16/2022] Open
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Luzzi S, Giotta Lucifero A, Spina A, Baldoncini M, Campero A, Elbabaa SK, Galzio R. Cranio-Orbito-Zygomatic Approach: Core Techniques for Tailoring Target Exposure and Surgical Freedom. Brain Sci 2022; 12:brainsci12030405. [PMID: 35326360 PMCID: PMC8946068 DOI: 10.3390/brainsci12030405] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 11/21/2022] Open
Abstract
Background: The cranio-orbito-zygomatic (COZ) approach is a workhorse of skull base surgery, and each of its steps has a precise effect on target exposure and surgical freedom. The present study overviews the key techniques for execution and tailoring of the COZ approach, focusing on the quantitative effects resulting from removal of the orbitozygomatic (OZ) bar, orbital rim, and zygomatic arch. Methods: A PRISMA-based literature review was performed on the PubMed/Medline and Web of Science databases using the main keywords associated with the COZ approach. Articles in English without temporal restriction were included. Eligibility was limited to neurosurgical relevance. Results: A total of 78 articles were selected. The range of variants of the COZ approach involves a one-piece, two-piece, and three-piece technique, with a decreasing level of complexity and risk of complications. The two-piece technique includes an OZ and orbitopterional variant. Superolateral orbitotomy expands the subfrontal and transsylvian corridors, increasing surgical freedom to the basal forebrain, hypothalamic region, interpeduncular fossa, and basilar apex. Zygomatic osteotomy shortens the working distance of the pretemporal and subtemporal routes. Conclusion: Subtraction of the OZ bar causes a tremendous increase in angular exposure of the subfrontal, transsylvian, pretemporal, and subtemporal perspectives avoiding brain retraction, allowing for multiangled trajectories, and shortening the working distance. The COZ approach can be tailored based on the location of the lesion, thus optimizing the target exposure and surgical freedom and decreasing the risk of complications.
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Affiliation(s)
- Sabino Luzzi
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
- Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Correspondence:
| | - Alice Giotta Lucifero
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Alfio Spina
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Matías Baldoncini
- Department of Neurological Surgery, Hospital San Fernando, Buenos Aires 1646, Argentina;
- Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires 1053, Argentina
| | - Alvaro Campero
- Laboratorio de Innovaciones Neuroquirúrgicas de Tucuman (LINT), Facultad de Medicina, Universidad Nacional de Tucumán, Tucuman 4000, Argentina;
- Department of Neurosurgery, Hospital Padilla, San Miguel de Tucumán, Tucuman 4000, Argentina
| | - Samer K. Elbabaa
- Department of Pediatric Neurosurgery, Leon Pediatric Neuroscience Center of Excellence, Arnold Palmer Hospital for Children, Orlando, FL 32806, USA;
| | - Renato Galzio
- Neurosurgery Unit, Maria Cecilia Hospital, 48033 Cotignola, Italy;
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Yağmurlu K. Editorial: Neurosurgery and Neuroanatomy. Brain Sci 2022; 12:brainsci12030341. [PMID: 35326297 PMCID: PMC8946273 DOI: 10.3390/brainsci12030341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Microsurgical anatomy is not only the backbone for neurosurgical operations, but also for technological innovations, novel surgical techniques, a better understanding of the etiopathogenesis of pathologies, and translational medicine from neuroscience to daily clinical practice [...]
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Affiliation(s)
- Kaan Yağmurlu
- Department of Neurological Surgery and Neuroscience, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
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