The combined pterional and orbitocygomatic approach to extensive tumours of the lateral and latero-basal orbit and orbital apex.

Using standardized transcranial (pterional, subfrontal, fronto-orbital) approaches, complete removal of tumours located in the latero-basal aspect of the orbit and the lateral orbital apex with or without extension to the temporal fossa is not possible or can only be achieved if excessive traction is applied to the contents of the orbit and the brain. In contrast, the combined pterional and orbitocygomatic approach provides unhindered access to the superior, lateral and latero-basal orbit, superior and inferior orbital fissure and, if required, to the temporal fossa including the foramina ovale and rotundum. Six patients with extensive orbital lesions underwent surgery using this technique with good operative results.