The zygomaticotemporal approach with medial petrosectomy for intradural lesions

The zygomaticotemporal approach with medial petrosectomy offers an alternative exposure for intradural lesions anterior to the brain stem. It improves access for tumours of the clivus and facilitates proximal control in low lying and giant basilar artery aneurysms. Twenty-three patients were operated on using this approach (12 aneurysms of the posterior circulation and 11 tumours). The permanent complications experienced with this exposure were ipsilateral hearing loss (two cases) and facial nerve palsy (one case). The experience in this series shows it is a useful alternative in accessing this difficult area.