[Orbital and/or zygomatic removal in an approach to lesions near the cranial base. Surgical technic, anatomic study and analysis of a series of 24 cases].

The authors describe the technique of removal of the orbital rim, the zygomatic arch and the combination of both, i.e., the orbito-zygomatic arch. Then they give the summary of an anatomical study in human cadavers (13 approaches), measuring the field view angle (F.V.A.) of various intra-cranial targets in the vicinity of the skull base after orbital and/or zygomatic removal associated to fronto-temporal craniotomy. Thanks to orbital and/or zygomatic removal, F.V.A. was increased on average, by 75% in the sub-frontal approach, 46% in the pterional approach, and 86% in the sub-temporal approach. Finally the authors illustrate the usefulness of these combined approaches in a series of 24 cases of various difficult lesions located in the vicinity of the skull base, operated on during the last 3 years.