SKULL BASE SURGERY WITH SUPERIOR ORBITOTOMY

Abstract

Three approaches to central cranial base lesions are reported based on experience with orbital advancement in craniosynostosis. The basal approach for large lesions is indicated for total superior orbitotomy after bilateral frontal craniotomy. The basal interhemispheric approach by superomedial orbitotomy with bilateral frontal craniotomy was used for midline, suprasellar and third ventricle lesions. The orbitozygomatic approach by superolateral orbitotomy after front-temporal craniotomy was performed for the spheno-orbital lesion, cavernous sinus lesion and high-placed basilar top aneurysm. Our surgical techniques for each approach are described with case presentations, and the management of frontal sinus, dural and bone defects are stressed to prevent of liquorrhea.