Improved subtemporal approach and frontotemporal-zygomatic arch subtemporal approach in resection of cavernous sinus tumors: a clinical comparative study

Abstract

Objective To compare the efficacy of the improved subtemporal approach and traditional frontotemporal-zygomatic arch subtemporal approach in resection of cavernous sinus tumors. Methods The clinical data of two groups of patients were analyzed retrospectively. There were 26 patients in an improved subtemporal approach (that is preauricular straight incision preserving zygomatic arch) group (group A). There were 14 females and 12 males, and 9 patients had meningioma, and 17 had trigeminal neurinoma. There were 22 patients in a traditional frontotemporal-zygomatic arch subtemporal approach group (group B). There were 13 females and 9 males, 8 patients had meningioma and 14 had trigeminal neurinoma. The incidence of total resection rate, cranial nerve complications of postoperative lateral wall of cavernous sinus in the patients of both groups were compared, and they were followed up regularly after procedure. Results There was no significant difference in the complete resection rate and the incidence of complications of the cranial nerves between the two groups; however, preserving the zygomatic arch subtemporal approach, the time of craniotomy was shortened significantly. The incidences of postoperative temporal branch injury of facial nerve and temporal muscle atrophy were reduced significantly. Conclusions Preauricular straight incision subtemporal approach can fully expose the cavernous sinus and preserve zygomatic arch. The surgery trauma and complications are less. It is a good choice for the removal of tumors in cavernous sinus areas. Key words: Cavernous sinus; Brain neoplasms; Subtemporal approach