Vol 44, No 2 (2010)

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Direct and remote outcome after treatment of tumours involving the subtemporal fossa and related structures with the extended subtemporal approach

Piotr Ładziński12, Henryk Majchrzak1, Cezary Szymczyk2, Wojciech Kaspera1, Mariusz Maliszewski1, Adam Maciejewski2, Janusz Wierzgoń2, Krzysztof Majchrzak1, Michał Tymowski1, Piotr Adamczyk1
DOI: 10.1016/S0028-3843(14)60006-2
Neurol Neurochir Pol 2010;44(2):148-158.

Abstract

Background and purpose

The aim of the study was to present our results of the surgical treatment of subtemporal fossa tumours and surrounding regions using the extended subtemporal approach.

Material and methods

Twenty-five patients (10 women, 15 men) with subtemporal fossa tumours were included in the study. The neurological and performance status of the patients were assessed before and after surgery as well as at the conclusion of treatment. The approximate volume of the operated tumour, its relation to large blood vessels and cranial nerves, as well as consistency and vascularisation were assessed.

Results

The symptom duration ranged from 2 to 80 months (mean: 14 months). In 44% of patients, headache was the predominant symptom. Less frequent symptoms were: paralysis of the abducent nerve and disturbances of the trigeminal nerve. Approximate volume of the tumours ranged from 13 to 169 cm3 (mean: 66 cm3). The most frequent histological diagnosis was meningioma (16%), followed by angiofibroma, neurinoma and adenocystic carcinoma (12%). Total or subtotal resection was achieved in 80% of patients.

Conclusions

The extended subtemporal approach allows for the removal of tumours of the subtemporal fossa and surrounding regions. This approach also allows one to remove tumours expanding in the regions surrounding the subtemporal fossa only. In such cases the subtemporal fossa constitutes the way of the surgical approach.

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Neurologia i Neurochirurgia Polska