Frontotemporal Craniotomy with Orbitozygomatic Osteotomy

Frontotemporal craniotomy with orbitozygomatic osteotomy is an adjunct to pterional craniotomy that allows greater rostral trajectory to midline structures. By removing the superior and lateral bony orbit, one gains a more anterior and inferior starting point for the approach than would be possible with a conventional pterional craniotomy.

Removal of the zygomatic arch enables inferior displacement of the temporalis muscle, allowing for a lower starting point for subtemporal visualization.

If a midline view of the suprasellar region is needed, a bifrontal craniotomy may be a better approach.

Access to the petrous apex and retrosellar space is limited and requires a long reach.