Dr. Jho's Temple-Incision Skull Base Surgery: Operation for Tentorial Meningioma, Trigeminal Neuroma, Cavernous sinus Tumor, Petroclival Meningioma, Cholesterol Granuloma, Cerebral Aneurysm: Subtemporal Skull Base Approach: Minimally Invasive Brain Tumor Surgery

Hae Dong Jho, M.D., Ph.D.

"Band-aid" Brain surgery for cavernous sinus tumors, tentorial meningiomas, cholesterol granulomas, trigeminal neurilemmomas, petroclival meningiomas and cerebral aneurysms

Facts About This Surgery

Provides an alternative to the conventional subtemporal craniotomy that often includes extensive incisions and skull bone removal

• Is less invasive because it utilizes a smaller skull hole and a smaller incision
• Is innovative because it does away with the need for brain retractors which reduces risk
• Is a direct surgical route for tumor resection or for surgical treatment of vascular lesions
• On average, patients stay 2 to 3 days in the hospital
• Postoperative incisions are covered by a "band-aid" type dressing, hence the name, "band-aid brain surgery"

Discussion

The traditional approach of a subtemporal craniotomy has been modified, and now tumors and vascular lesions of the middle skull base, cavernous sinus, petrous bone and upper posterior fossa can be reached through a smaller skull hole and through a smaller skin incision. A two inch skin incision and a compact and strategically placed skull hole is made at the temple for access to the middle fossa, cavernous sinus, and tentorial regions. The incision is covered by a "band-aid" after surgery and patients generally only need to stay in the hospital for two or three days. This surgery is a minimally invasive alternative for both tumors and vascular lesions.

Images

            

MRI scan images including axial view (left) and coronal view (right) reveal a large meningioma involving the cavernous sinus and tentorium.

                

Subsequent postoperative MRI views plus a postoperative CT scan view (far right) demonstrate complete tumor resection. The patient did well following surgery with some left sided facial numbness.

A patient after subtemporal approach with a postoperative bandage.