THE COMBINED PTERIONAL AND ORBITOCYGOMATIC APPROACH TO EXTENSIVE TUMORS OF THE LATERAL AND LATERO-BASAL ORBIT AND ORBITAL APEX

Using standardized transcranial (pterional, subfrontal fronto-orbital) approaches, complete removal of rumours located in the latero-basal a spect of the orbit and the lateral orbital apex with or without extens ion to the temporal fossa is not possible or can only be achieved if e xcessive traction is applied to the contents of the orbit and the brai n. In contrast, the combined pterional and orbitocygomatic approach pr ovides unhindered access to the superior, lateral and latero-basal orb it, superior and inferior orbital fissure and, if required, to the tem poral fossa including the foramina ovale and rotundum. Six patients wi th extensive orbital lesions underwent surgery using this technique wi th good operative results.