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CASE REPORT
Year : 2015  |  Volume : 10  |  Issue : 3  |  Page : 250-252

Safe fronto-orbito-zygomatic osteotomy using a diamond-coated threadwire saw in orbito-zygomatic craniotomy


Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan

Correspondence Address:
Kojiro Wada
Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama - 359-8513
Japan
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Source of Support: Nil, Conflict of Interest: None declared.


DOI: 10.4103/1793-5482.161190

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Orbito-zygomatic craniotomy is a widely accepted skull-based technique, but osteotomy at the malar eminence (ME) is complicated. We have developed a safe fronto-orbito-zygomatic (FOZ) osteotomy by creating small guide burr holes in the superior and lateral parts of the orbital wall and cutting the bone using a diamond-coated threadwire saw. This method involves standard two-piece osteotomy by creating small superior and lateral guide orbital burr holes instead of sectioning into the superior and inferior orbital fissures. The guide burr holes are connected using a diamond-coated threadwire saw to create the FOZ bar. This method was applied to the treatment of four patients with skull-based tumors or internal carotid and basilar artery aneurysms. Postoperative three-dimensional bone density computed tomography showed minimum bone gap in the ME. No craniotomy-related complication has occurred. FOZ osteotomy by creating guide burr holes in the orbital wall and cutting the bone using a diamond-coated threadwire saw is safe and results in minimum bone gap in the ME.


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