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Updated: Mar 23, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

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Orbitozygomatic craniotomy in three pieces: tips and tricks.

Feres Chaddad Neto¹, Hugo Leonardo Doria Netto¹, José Maria Campos Filho¹

¹Departamento de Neurologia, Universidade Federal de São Paulo, Sao Paulo, SP, Brazil.

Arquivos De Neuro-Psiquiatria

|April 7, 2016

Summary

This summary is machine-generated.

This study details a three-piece orbitozygomatic craniotomy technique used in 49 patients for treating vascular lesions and skull base tumors. The approach resulted in no permanent injuries, demonstrating its safety and efficacy in neurosurgery.

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Area of Science:

Neurosurgery
Surgical Technique
Skull Base Surgery

Background:

The orbitozygomatic craniotomy is a complex surgical approach.
Its application in treating diverse intracranial pathologies requires detailed understanding.
Standardized descriptions aid in surgical training and patient care.

Purpose of the Study:

To provide a didactic description of the three-piece orbitozygomatic craniotomy.
To detail the surgical technique employed in a series of patients.
To document the outcomes associated with this specific craniotomy approach.

Main Methods:

A retrospective analysis of 49 patients undergoing orbitozygomatic craniotomy between 2002 and 2011.
Surgical technique described in detail, focusing on the three-piece approach.
Data collected on patient diagnoses, surgical procedures, and complications.

Main Results:

The approach was utilized for 27 patients with vascular lesions (e.g., aneurysms, arteriovenous malformations) and 22 with skull base tumors (e.g., meningiomas, gliomas).
Specific vascular pathologies included mesencephalic cavernous angiomas, basilar tip aneurysms, and interpeduncular cistern AVMs.
Neoplastic lesions comprised meningiomas, interpeduncular hamartomas, and third ventricle floor gliomas.
No permanent neurological deficits were observed; only minimal transient complications occurred.

Conclusions:

The three-piece orbitozygomatic craniotomy is a safe and effective technique for accessing complex cranial pathologies.
The descriptive approach aids in understanding and executing this intricate surgical procedure.
The study highlights the successful application of this craniotomy in a significant patient cohort with favorable outcomes.