| Description |
The frontotemporal, so-called "pterional" approach has evolved with the contribution of many neurosurgeons over the past century. It has stood the test of time and been the most commonly used transcranial approach in neurosurgery. In its current form, drilling the sphenoid wing as far down as the superior orbital fissure with or without the removal of the anterior clinoid, thinning the orbital roof, and opening the Sylvian fissure and basal cisterns are the hallmarks of this approach. Tumoral and vascular lesions involving the sellar/parasellar area, anterior and anterolateral circle of Willis, middle cerebral artery, anterior brain stem, upper basilar artery, insula, basal ganglia, mesial temporal region, anterior cranial fossa, orbit, and optic nerve are within the reach of the frontotemporal approach. In this paper, we review the origins, evolution, and modifications of the frontotemporal approach and update the discussion of some of the related derivative procedures. |
