Orbitozygomatic Craniotomy

Indications and Contraindications

• The addition of the orbitozygomatic (OZ) osteotomies to the fronto-temporosphenoidal craniotomy increases the surgeon's workspace and minimizes the brain retraction required to reach deep-seated pathology. The orbital osteotomy allows increased visualization above the anterior clinoids while the zygomatic osteotomy gives additional access to the middle fossa by permitting the temporal lobe to be mobilized laterally.

• Pathology of the anterior cranial fossa, suprasellar/parasellar region, medial sphenoid wing/cavernous sinus, middle fossa/cavernous sinus, posterior fossa/upper clivus. Upper posterior fossa access can be expanded through the addition of a posterior clinoidectomy and/or anterior petrosectomy.

• Other approaches are more suitable in treating sellar/parasellar tumors with superoanterior extension (e.g. bifrontal craniotomy).

Surgical Procedure