Bicoronal frontobasal approach with a limited, midline orbital bar osteotomy – a technical note

Abstract

The frontobasal approach remains a workhorse for removing large olfactory groove meningiomas. Removal of the orbital bar in addition to standard bifrontal craniotomy allows for additional basal exposure, minimising brain retraction and allowing early and direct access to both the vascular supply and dural origin of this tumour. Here, we describe a simple yet effective modification to the standard orbital bar osteotomy. It has the benefit of being simpler and faster with improved cosmesis compared with an osteotomy of the entire orbital bar. It also has the advantage of not requiring manipulation of the supraorbital nerves or intraorbital or periorbital dissection.

Keywords::

• cranio-orbital approach
• meningioma
• olfactory groove meningioma
• skull base tumour

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.