Modified Orbitozygomatic Craniotomy Approach for a Recurrent Orbital Tumor in a Pediatric Patient

Background: This report aims to present the case of a pediatric patient with a recurrent tumor in the superolateral orbit. Clinical Presentation: An 8-year-old patient was initially treated for a tumor in the superolateral orbit via a transconjunctival approach. The histopathological diagnosis was epidermoid cyst. Postoperatively, chronic inflammation and fistula developed in the lateral canthus area. Magnetic resonance imaging revealed a residual tumor posterior to the original tumor location. The patient was treated via a modified orbitozygomatic (mOZ) craniotomy approach that was originally applied in neurosurgery, and complete tumor removal was achieved. A temporary paralysis of the frontotemporal branch of the facial nerve was observed and fully resolved within one month following surgery. At the 18th month of follow-up, the visual, neurological, and cosmetic results were found to be satisfactory. Conclusions: mOZ craniotomy can be used to access and operate on recurrent orbital tumors in pediatric patients where other more aggressive surgical approaches should be avoided.