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CC BY 4.0 · Indian Journal of Neurosurgery 2024; 13(01): 011-019
DOI: 10.1055/s-0042-1744249
Original Article

Fronto-Temporo-Orbito-Zygomatic Approach with Orbital Reconstruction in Lesions causing Unilateral Non-pulsating Proptosis

Mohab Darwish 
1   Attending of Neurosurgery, Department of Neurosurgery, Minia University Hospital and school of Medicine, Minia, Egypt
,
Ahmed Moawad
1   Attending of Neurosurgery, Department of Neurosurgery, Minia University Hospital and school of Medicine, Minia, Egypt
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Abstract

Background Unilateral non-pulsating proptosis can be caused by lesions with intraorbital extensions compressing the globe including sphenoid wing en plaque meningiomas and paranasal sinuses lesions.

Patients and Methods We operated on 20 patients with unilateral non-pulsating proptosis using fronto-temporo-orbito-zygomatic (FTOZ) approach with orbital reconstruction in six patients. Eighteen patients had sphenoid wing en plaque meningioma, 1 patient had paranasal sinuses fungal infection with intraorbital and intracranial extension, and 1 patient had frontal sinus dermoid with intraorbital extension.

Results Proptosis was corrected in 50% of the patients, improved in 25%, and remained stationary in 25%. Vision improved in three patients, remained stationary in three, and deteriorated in one patient. Two patients had temporary oculomotor ophthalmoplegia that resolved within 3 months.

Conclusion Although it is an invasive approach, FTOZ gives excellent exposure of the orbit and anterolateral skull base that allows the excision of intracranial lesions with orbital extension. If needed, the orbit could be reconstructed easily due to excellent exposure.

Keywords

proptosis - FTOZ - en plaque meningioma


Publication History

Article published online:
07 October 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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