The lateral orbitotomy approach: Technical nuances and video-illustration

The lateral orbitotomy approach is a minimally-invasive transorbital technique that was originally developed to address orbital pathologies. With the increased understanding of orbital anatomy and multidisciplinary collaboration between neurosurgeons and oculoplastic surgeons, the approach has been expanded to address various pathologies of the anterior and middle cranial fossae, and intrinsic brain pathologies. Clipping select aneurysms and resecting both intrinsic and extra-axial brain tumors were made possible through a small skin incision around the eye. The lateral orbitotomy offers optimal visualization to pathologies located inferior to the anterior clinoid process, anterior to Meckel's cave, lateral to the optic nerve, and medial to foramen ovale. In this report, the authors delineate the indications, advantages, and limitations of the lateral orbitotomy approach and discuss related technical nuances and common pitfalls. This report aims to provide a practical educational resource for neurosurgery trainees and junior neurosurgeons through high-quality dissections and 3D 4 K video presentations.