We use a modified orbitozygomatic craniotomy to fit the location and nature of lesions more precisely. Our goal is to minimize the risks associated with skull base exposure without sacrificing the advantages offered by the more extensive orbitozygomatic approach. We use two major modifications of the traditional orbitozygomatic craniotomy, including supraorbital and subtemporal variations. The supraorbital modification combines a pterional craniotomy with a supralateral orbitotomy to access lesions in the anterior and middle cranial fossae. The subtemporal modification unites a pterional craniotomy with mobilization of the zygomatic arch to expose the temporal fossa up to the tentorial edge. In this article we revisit previous surgical solutions and describe step-by-step instructions for the proposed modifications.
anterior communicating artery