{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:10:50Z","timestamp":1779527450040,"version":"3.53.1"},"reference-count":56,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2008,12]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>The extradural temporopolar approach is used for enhanced exposure of the cavernous sinus and petroclival regions in the treatment of complex lesions not amenable to sole treatment via radiosurgical or endovascular methods. The authors' objective was to review the indications, surgical experience, and operative technique in a series of patients who underwent surgery with this approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors conducted a retrospective review to identify patients who underwent a temporopolar approach from 1992 to 2008. An orbitozygomatic craniotomy was frequently used, followed by extradural retraction of the temporal lobe. A sequential progression of bone removal at the anterior and middle skull base, followed by opening the layers of the lateral wall of the cavernous sinus was next performed to safely retract the brain and widen the exposure to the cavernous sinus, interpeduncular fossa, and upper petroclival regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty-six patients were identified and included in the study. The mean patient age was 49 years. The main indications for surgery were as follows: meningioma (25 patients, 38%), basilar artery aneurysm (11 patients, 17%), trigeminal schwannoma (7 patients, 11%), chordoma (5 patients, 7%), hemangioma (3 patients, 5%), pituitary adenoma (3 patients, 5%), superior cerebellar artery aneurysm (3 patients, 5%), and other lesions (9 patients, 14%). Complications included hemiparesis in 4 patients (6%), infarcts in 4 patients (6%), transient aphasia in 1 patient (1.5%), and cranial nerve paresis in 20 patients (30%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The extradural temporopolar approach offers a relatively safe and wide exposure of the sphenocavernous and petroclival regions. Mobilization of the cranial nerves and internal carotid artery allow gentle brain retraction and maximal preservation of venous outflow. This is an advantageous approach to large tumors in these regions and for complex upper basilar artery or superior cerebellar artery aneurysms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/foc.2008.25.12.e3","type":"journal-article","created":{"date-parts":[[2008,11,26]],"date-time":"2008-11-26T11:56:31Z","timestamp":1227700591000},"page":"E3","source":"Crossref","is-referenced-by-count":25,"title":["The extradural temporopolar approach: a review of indications and operative technique"],"prefix":"10.3171","volume":"25","author":[{"given":"Gabriel","family":"Zada","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Diaz","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Texas Health Science Center at San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven L.","family":"Giannotta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0250003","series-title":"Acta Neurochir Suppl (Wien)","first-page":"166","article-title":"The petrosal approach: indications, technique, and results","volume":"53","author":"Al-Mefty","year":"1991"},{"key":"b2-0250003","series-title":"Neurosurgery","first-page":"510","article-title":"Petrosal approach for petroclival meningiomas","volume":"22","author":"Al-Mefty","year":"1988"},{"key":"b3-0250003","series-title":"J Neurosurg","first-page":"20","article-title":"Petroclival meningiomas: surgical experience in 109 cases","volume":"84","author":"Couldwell","year":"1996"},{"key":"b4-0250003","series-title":"Neurosurgery","first-page":"754","article-title":"Cranial base surgical techniques for large sphenocavernous meningiomas: technical note","volume":"46","author":"Day","year":"2000"},{"key":"b5-0250003","series-title":"Neurosurgery","first-page":"233","article-title":"The surgical management of trigeminal neuromas","volume":"42","author":"Day","year":"1998"},{"key":"b6-0250003","series-title":"J Neurosurg","first-page":"544","article-title":"Cranial base approaches to posterior circulation aneurysms","volume":"87","author":"Day","year":"1997"},{"key":"b7-0250003","series-title":"J Neurosurg","first-page":"230","article-title":"Extradural temporopolar approach to lesions of the upper basilar artery and infrachiasmatic region","volume":"81","author":"Day","year":"1994"},{"key":"b8-0250003","series-title":"Neurol Med Chir (Tokyo)","first-page":"70","article-title":"Basilar bifurcation aneurysms","volume":"38","author":"de Sousa","year":"1998"},{"key":"b9-0250003","series-title":"Acta Neurochir Suppl","first-page":"99","article-title":"Extradural approach to intracavernous ICA aneurysms","volume":"72","author":"Dolenc","year":"1999"},{"key":"b10-0250003","series-title":"Acta Neurochir (Wien)","first-page":"55","article-title":"Frontotemporal epidural approach to trigeminal neurinomas","volume":"130","author":"Dolenc","year":"1994"},{"key":"b11-0250003","series-title":"Clin Neurosurg","first-page":"240","article-title":"Surgery of vascular lesions of the cavernous sinus","volume":"36","author":"Dolenc","year":"1990"},{"key":"b12-0250003","series-title":"Neurosurgery","first-page":"542","article-title":"Transcranial epidural approach to pituitary tumors extending beyond the sella","volume":"41","author":"Dolenc","year":"1997"},{"key":"b13-0250003","series-title":"Clin Neurosurg","first-page":"96","article-title":"The treatment of aneurysms of the posterior circulation","volume":"26","author":"Drake","year":"1979"},{"key":"b14-0250003","series-title":"Br J Neurosurg","first-page":"134","article-title":"The extradural approach to lesions involving the cavernous sinus","volume":"11","author":"Goel","year":"1997"},{"key":"b15-0250003","series-title":"Neurol Med Chir (Tokyo)","first-page":"112","article-title":"Extradural approach for cavernous hemangioma of the cavernous sinus: experience with 13 cases","volume":"43","author":"Goel","year":"2003"},{"key":"b16-0250003","series-title":"J Neurosurg","first-page":"699","article-title":"A combined orbitozygomatic infratemporal epidural and subdural approach for lesions involving the entire cavernous sinus","volume":"71","author":"Hakuba","year":"1989"},{"key":"b17-0250003","series-title":"Neurosurgery","first-page":"105","article-title":"Orbitozygomatic temporopolar approach for a high basilar tip aneurysm associated with a short intracranial internal carotid artery: a new surgical approach","volume":"28","author":"Ikeda","year":"1991"},{"key":"b18-0250003","series-title":"Neurosurgery","first-page":"1385","article-title":"Gamma knife radiosurgery for benign cavernous sinus tumors: quantitative analysis of treatment outcomes","volume":"54","author":"Kuo","year":"2004"},{"key":"b19-0250003","series-title":"Yonsei Med J","first-page":"120","article-title":"Extradural approach to the lateral sellar compartment","volume":"42","author":"Lee","year":"2001"},{"issue":"6","key":"b20-0250003","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Optimization of the operative corridor for the resection of craniopharyngiomas in children: the combined frontoorbitozygomatic temporopolar approach. Technical note","volume":"3","author":"Levy","year":"1997"},{"key":"b21-0250003","series-title":"Neurol Neurochir Pol","first-page":"27","article-title":"Approaches to posterior circulation aneurysms and results of the operations","volume":"34","author":"Majchrzak","year":"2000"},{"key":"b22-0250003","series-title":"Clin Neurol Neurosurg","first-page":"104","article-title":"Surgical treatment of intracavernous trigeminal schwannomas via a fronto-temporal epidural approach","volume":"106","author":"Mariniello","year":"2004"},{"key":"b23-0250003","series-title":"J Neurosurg","first-page":"474","article-title":"A surgical approach to the cavernous portion of the carotid artery. 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aneurysms","volume":"25","author":"Shiokawa","year":"1989"},{"key":"b28-0250003","series-title":"Neurosurgery","first-page":"483","article-title":"Extradural transcavernous approach to cavernous sinus hemangiomas","volume":"60","author":"Suri","year":"2007"},{"key":"b1-0250003","series-title":"Acta Neurochir Suppl (Wien)","first-page":"166","article-title":"The petrosal approach: indications, technique, and results","volume":"53","author":"Al-Mefty","year":"1991"},{"key":"b2-0250003","series-title":"Neurosurgery","first-page":"510","article-title":"Petrosal approach for petroclival meningiomas","volume":"22","author":"Al-Mefty","year":"1988"},{"key":"b3-0250003","series-title":"J Neurosurg","first-page":"20","article-title":"Petroclival meningiomas: surgical experience in 109 cases","volume":"84","author":"Couldwell","year":"1996"},{"key":"b4-0250003","series-title":"Neurosurgery","first-page":"754","article-title":"Cranial base surgical techniques for large sphenocavernous 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aneurysms","volume":"72","author":"Dolenc","year":"1999"},{"key":"b10-0250003","series-title":"Acta Neurochir (Wien)","first-page":"55","article-title":"Frontotemporal epidural approach to trigeminal neurinomas","volume":"130","author":"Dolenc","year":"1994"},{"key":"b11-0250003","series-title":"Clin Neurosurg","first-page":"240","article-title":"Surgery of vascular lesions of the cavernous sinus","volume":"36","author":"Dolenc","year":"1990"},{"key":"b12-0250003","series-title":"Neurosurgery","first-page":"542","article-title":"Transcranial epidural approach to pituitary tumors extending beyond the sella","volume":"41","author":"Dolenc","year":"1997"},{"key":"b13-0250003","series-title":"Clin Neurosurg","first-page":"96","article-title":"The treatment of aneurysms of the posterior circulation","volume":"26","author":"Drake","year":"1979"},{"key":"b14-0250003","series-title":"Br J Neurosurg","first-page":"134","article-title":"The extradural approach to lesions involving the cavernous 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analysis of treatment outcomes","volume":"54","author":"Kuo","year":"2004"},{"key":"b19-0250003","series-title":"Yonsei Med J","first-page":"120","article-title":"Extradural approach to the lateral sellar compartment","volume":"42","author":"Lee","year":"2001"},{"issue":"6","key":"b20-0250003","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Optimization of the operative corridor for the resection of craniopharyngiomas in children: the combined frontoorbitozygomatic temporopolar approach. 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