{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T17:15:43Z","timestamp":1788628543194,"version":"build-2803163510"},"reference-count":30,"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:p>Central skull base lesions in the upper retroclival and petroclival regions can be challenging to access because of their location anterior to the brainstem. Several transpetrosal approaches have been developed to access the petroclival junction, including anterior petrosal (anterior petrosectomy), posterior petrosal (retrolabyrinthine, translabyrinthine, transcochlear), and combined petrosal approaches. The anterior petrosal approach is best suited for upper petroclival lesions located anterior and superior to the internal auditory canal and superior to the inferior petrosal sinus. This approach provides direct access to the anteromedial cerebellopontine angle, petrous apex, Meckel cave, and ventrolateral brainstem between the trigeminal root and the facial nerve. The authors describe their modification of an anterior petrosal approach, the so-called transzygomatic extended middle fossa approach, which incorporates a zygomatic osteotomy, anterior mobilization of the V3, and extensive middle fossa drilling. This exposure provides a wider surgical corridor for direct view of the clivus and ventral brainstem.<\/jats:p>","DOI":"10.3171\/foc.2008.25.12.e5","type":"journal-article","created":{"date-parts":[[2009,1,7]],"date-time":"2009-01-07T13:11:35Z","timestamp":1231333895000},"page":"E5","source":"Crossref","is-referenced-by-count":20,"title":["Transzygomatic extended middle fossa approach for upper petroclival skull base lesions"],"prefix":"10.3171","volume":"25","author":[{"given":"Jin-cheng","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Evanston Hospital, NorthShore University HealthSystem, Evanston, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James K.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Evanston Hospital, NorthShore University HealthSystem, Evanston, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0250005","series-title":"Neurosurgery","first-page":"1225","article-title":"The Kawase approach to retrosellar and upper clival basilar aneurysms","volume":"44","author":"Aziz","year":"1999"},{"key":"b2-0250005","series-title":"Neurosurgery","first-page":"708","article-title":"Combined petrosal approach to petroclival meningiomas","volume":"51","author":"Cho","year":"2002"},{"key":"b3-0250005","series-title":"J Neurosurg","first-page":"877","article-title":"Subfascial and submuscular methods of temporal muscle dissection and their relationship to the frontal branch of the facial nerve. 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Report Of 50 Cases","volume":"78","author":"House","year":"1963"},{"key":"b6-0250005","series-title":"Laryngoscope","first-page":"1363","article-title":"Surgical exposure of the internal auditory canal and its contents through the middle, cranial fossa","volume":"71","author":"House","year":"1961"},{"key":"b7-0250005","series-title":"Neurosurgery","first-page":"869","article-title":"Anterior transpetrosal-transtentorial approach for sphenopetroclival meningiomas: surgical method and results in 10 patients","volume":"28","author":"Kawase","year":"1991"},{"key":"b8-0250005","series-title":"J Neurosurg","first-page":"857","article-title":"Transpetrosal approach for aneurysms of the lower basilar artery","volume":"63","author":"Kawase","year":"1985"},{"key":"b9-0250005","series-title":"Neurosurgery","first-page":"309","article-title":"Increasing exposure of the petrous internal carotid artery for revascularization using the transzygomatic extended middle fossa approach: a cadaveric morphometric study","volume":"59","author":"Liu","year":"2006"},{"key":"b10-0250005","series-title":"Neurosurgery","first-page":"84","article-title":"The anterior subtemporal, medial transpetrosal approach to the upper basilar artery and ponto-mesencephalic junction","volume":"43","author":"MacDonald","year":"1998"},{"key":"b11-0250005","series-title":"Neurosurgery","first-page":"461","article-title":"Transpetrosal approach: surgical anatomy and technique","volume":"33","author":"Miller","year":"1993"},{"key":"b12-0250005","series-title":"J Neurosurg","first-page":"336","article-title":"Orbitozygomatic craniotomy. 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