Indications and Safety of the Zygomatic Osteotomy in Middle Cranial Fossa Surgery: A Retrospective Cohort Review
Document Type
Article
Publication Date
2019
Keywords
zygomatic osteotomy, middle cranial fossa, skull base, surgical approaches, surgical adjuncts
Digital Object Identifier (DOI)
https://doi.org/10.1055/s-0038-1668519
Abstract
Background: Zygomatic osteotomy, an adjunct to middle cranial fossa (MCF) surgical approaches, improves the superior-inferior angle of approach and minimizes temporal lobe retraction. However, a decision-making algorithm for selective use of the zygomatic osteotomy and the impact of the zygomatic osteotomy on surgical complications have not been well documented.
Objective: We described an algorithm for deciding whether to use a zygomatic osteotomy in MCF surgery and evaluated complications associated with a zygomatic osteotomy.
Methods: A retrospective review of MCF cases over 11 years at our academic tertiary referral center was conducted. Demographic variables, tumor characteristics, surgical details, and postoperative complications were extracted.
Results: Of the 87 patients included, 15 (17%) received a zygomatic osteotomy. Surgical trajectory oriented from anterior to posterior (A-P) was significantly correlated with the use of the zygomatic osteotomy. Among the cases approached from A-P, we found (receiver-operating characteristic curve) that the cut-off tumor size that predicted a zygomatic osteotomy was 30 mm. Of the 87 cases included, 15 patients had a complication. The multivariate logistic regression model failed to reveal any significant correlation between complications and zygomatic osteotomies.
Conclusions: We found that the most important factor determining the use of a zygomatic osteotomy was anticipated trajectory. A-P approaches were most highly correlated with zygomatic osteotomy. Within those cases, a lesion size cut-off of 30 mm was the secondary predicting factor of zygomatic osteotomy use. The odds of suffering a surgical complication were not significantly increased by use of zygomatic osteotomy.
Was this content written or created while at USF?
Yes
Citation / Publisher Attribution
Journal of Neurological Surgery Part B, v. 80, issue 3, p. 225-231
Scholar Commons Citation
Neal, Elliot; Pressman, Elliot; Athienitis, Alexia; Turner, Adam; Ma, Shunchang; Rao, Gautam; Primiani, Christopher; Agarwalla, Pankaj; van Loveren, Harry; and Agazzi, Siviero, "Indications and Safety of the Zygomatic Osteotomy in Middle Cranial Fossa Surgery: A Retrospective Cohort Review" (2019). Neurosurgery and Brain Repair Faculty Publications. 66.
https://digitalcommons.usf.edu/nbr_facpub/66
