Supraorbital craniotomy by fracture of the anterior orbital roof

Technical note

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  • 1 Department of Surgery, Division of Neurosurgery, Oregon Health Sciences University, Portland, Oregon; and Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, Virginia
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✓ The authors describe a new and rapid method to safely perform a supraorbital craniotomy. This technique can be used when tumor does not invade the orbital roof. Previous descriptions of the supraorbital craniotomy involved exposure of the frontal sinus by removing its anterior wall and using the Gigli saw to separate the orbital roof. This new approach avoids removal of the anterior frontal sinus wall and separates the supraorbital bone flap from the calvaria by fracturing the anterior orbital roof forward. In addition, a method for harvesting a laterally based pericranium and muscle pedicle that contains a section of contralateral temporalis muscle is described. This vascularized pedicle can be used for repair of cerebrospinal fluid leaks or bone defects along the anterior fossa floor and orbit.

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  • 1.

    Delashaw JB Jr, , Tedeschi H, & Rhoton AL: Modified supraorbital craniotomy: technical note. Neurosurgery 30:954956, 1992 Delashaw JB Jr, Tedeschi H, Rhoton AL: Modified supraorbital craniotomy: technical note. Neurosurgery 30:954–956, 1992

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  • 2.

    Jane JA: Frontal approach to orbital and parasellar structures, in Wilson CB (ed): Neurosurgical Procedures: Personal Approaches to Classic Operations. Baltimore: Williams & Wilkins, 1992, pp 1020 Jane JA: Frontal approach to orbital and parasellar structures, in Wilson CB (ed): Neurosurgical Procedures: Personal Approaches to Classic Operations. Baltimore: Williams & Wilkins, 1992, pp 10–20

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  • 3.

    Jane JA, , Park TS, & Pobereskin LH, et al: The supraorbital approach: technical note. Neurosurgery 11:537542, 1982 Jane JA, Park TS, Pobereskin LH, et al: The supraorbital approach: technical note. Neurosurgery 11:537–542, 1982

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  • 4.

    Johns ME, , Kaplan MJ, & Jane JA, et al: Supraorbital rim approach to the anterior skull base. Laryngoscope 94:11371139, 1984 Johns ME, Kaplan MJ, Jane JA, et al: Supraorbital rim approach to the anterior skull base. Laryngoscope 94:1137–1139, 1984

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  • 5.

    Maroon JC, , Abla AA, & Kennerdell JS: Transfrontal approach to orbital tumors, in Wilson CB (ed): Neurosurgical Procedures: Personal Approaches to Classic Operations. Baltimore: Williams & Wilkins, 1992, pp 19 Maroon JC, Abla AA, Kennerdell JS: Transfrontal approach to orbital tumors, in Wilson CB (ed): Neurosurgical Procedures: Personal Approaches to Classic Operations. Baltimore: Williams & Wilkins, 1992, pp 1–9

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  • 6.

    Wolff E: Anatomy of the Eye and Orbit, ed 7. Philadelphia: WB Saunders, 1976, pp 14 Wolff E: Anatomy of the Eye and Orbit, ed 7. Philadelphia: WB Saunders, 1976, pp 1–4

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