Mid-skull Baseの病変に対するInfratemporal Fossa Approach—その有用性，手術解剖と術中の工夫

Infratemporal Fossa Approach for Mid-skull Base Lesion : its usefulness, surgical anatomy, and intraoperative device

I．はじめに

　頭蓋底外科の発達により，従来到達することさえ極めて困難であったような病変に対しても手術適応が広がってきた．今回，われわれはmid-skull-baseの脊索腫の症例に対し，infratemporal fossa approach（Fischのtype C approach^3,4,6,12））を使用し安全に摘出しえた．手術解剖を述べるとともにわれわれの工夫も含め本到達法の有用性を報告する．

The usefulness of the infratemporal fossa type C approach is reported through a presentation of a case of clival chordoma, which was successfully treated by this approach. Although it is complicated and in-cludes some demerits, this approach gives a shorter and wider access to mid-skull base pathology than other approaches. Among the demerits, deformity of the temporal region caused by extensive drilling of the bone could be minimized by cosmetic mastoidectomy, which was first applied during this approach by the authors. The surgical anatomy for this approach is demonstrated using a cadaver specimen.