안면골 절단술을 통한 두개기저부 접근법

Transfacial approaches to the skull base

Development of various craniofacial osteotomies and rigid fixation system allows to approach the skull base with more ease and safety. Transfacial approaches including transzygomatic, transmaxillary and transmandibular approach using osteotmies of the zygoma, Le Fort I, hemimaxillotomy and parasagittal mandibulotomy are described and discussed. According to the author s experience including 14 cases, trnaszygomatic approach offers the best technique with wide exposure of middle cranial fossa, infratemporal fossa, pterygoid space, and its combined technique with transmaxillary or transmandibular approach exposes clivus and upper cervical spine. Trnasmandibular approach exposes the cental base of skull better than transmaxillary approach with possibility of neck dissection.