A SURGICAL TECHNIQUE TO AVOID POSTOPERATIVE ENOPHTHALMOS IN THE CRANIOORBITAL APPROACH

The authors describe a surgical technique to avoid postoperative enoph thalmos when using the cranioorbital approach. To perform osteotomies with a less demanding technique, two separate bone flaps were created: 1) a free frontotemporal bone flap and 2) en bloc removal of the supe rior and lateral orbital rims. Because the latter bone flap includes b oth the orbital roof and the posterolateral wall of the orbit with the greater wing of the sphenoid bone, unnecessary bone defects in the la teral orbital wall are avoided. The technique has been performed in se ven patients treated for medially located skull base neoplasms or comp lex anterior circulation aneurysms without postoperative enophthalmos or other cosmetic problems. The authors believe this cranioorbital app roach, with its simpler, less invasive surgical technique, offers a de finite advantage by avoiding postoperative enophthalmos.