THIEME Technical Note | Nota Técnica 257 Osteoplastic Orbitozygomatic-Mastoid- Transattical Craniotomy Craniotomia orbitozigomático-mastóideo-transatical osteoplástica Ilton Guenhiti Shinzato1,2,3,4 Felipe Bouchabki de Almeida Guardini4,5 Fernando Kobayashi4,5 1 Neurosurgery Residency Program Supervisor of Santa Casa, Universidade Address for correspondence Ilton Guenhiti Shinzato, MD, DSc, Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil Neurosurgery Service, Santa Casa Hospital, Rua Eduardo Santos 2 DSc, COPPE/UFRJ, Rio de Janeiro, RJ, Brazil; Thesis Research done at Pereira, 88, 79002-251, Campo Grande, MS, Brazil Teikyo University, Chiba, Japan (e-mail:
[email protected]). 3 TitularMemberofABNc,ABORL,FLANC,WFNS;ActiveMemberof the Walter E. Dandy Neurosurgical Society, St. Louis, United States 4 Titular Member of Brazilian Neurosurgery Society – SBN, São Paulo, SP, Brazil 5 Neurosurgeon, Residency at Santa Casa, Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil Arq Bras Neurocir 2016;35:257–269. Abstract Objective The objective of this study is to introduce and describe a surgical technique called Osteoplastic Orbitozygomatic-Mastoid-Transattical Craniotomy (Osteoplastic OZ-MT) and to show the possibility of accomplishing osteoplastic craniotomies for other classical lateral transcranial approaches. Technique The Osteoplastic OZ-MT combines many lateral transcranial approaches. The surgical approach involves structures of lateral and basal portions of the skull, from the frontal bone, superolateral-inferolateral-posterolateral walls of the orbit, zygoma, zygomatic process, sphenoid greater and lesser wings, temporal fossa, mandibular fossa, zygomatic process of the temporal bone, petrous pyramid, mastoid, up to the parietal and occipital regions. The temporal muscle is totally preserved and attached to the one-piece-only bone flap.