Skull Base 2001; 11(2): 093-098
DOI: 10.1055/s-2001-14441
ORIGINAL ARTICLES

Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Microsurgical and Endoscopic Approaches to the Basilar Bifurcation: Quantitative Comparison of Combined Pterional/Anterior Temporal and Orbitozygomatic Extended Approaches

Anil Nanda, Prasad S.S.V. Vannemreddy, David A. Vincent
  • Department of Neurosurgery, Louisiana State University Medical Center, Shreveport, Louisiana
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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

To determine the most effective route to the upper third of the basilar artery, 10 cadaver dissections were performed comparing the exposure gained using the combined pterional/anterior temporal approach and the orbitozygomatic extended approach. Endoscopic evaluation through an eyebrow incision in each dissection helped determine whether any advantage was conferred by the cranial base approach. This also served to assess the benefit of using the endoscope as an adjunct to open procedures in evaluating the opticocarotid and retrocarotid routes to the basilar artery. The results of cadaveric dissections suggest that compared with the exposure afforded by the combined pterional/anterior temporal approach, the orbitozygomatic extended approach yields an increase of 8 cm in the anteroposterior axis and 10 cm in the superoinferior axis. Furthermore, as expected, the increases in visibility were directed anteriorly and posteriorly. When employed through the craniotomy site during aneurysm clipping, endoscopy was found to be potentially useful in assessing the contralateral elements of the upper basilar complex.

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