{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:39:45Z","timestamp":1783420785753,"version":"3.54.6"},"reference-count":78,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The authors aim to describe the advantages, utility, and disadvantages of the transpalpebral mini-orbitozygomatic (MOZ) approach for tumors of the lateral and superior orbit, orbital apex, anterior clinoid, anterior cranial fossa, middle cranial fossa, and parasellar region.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The surgical approach from skin incision to closure is described while highlighting key technical and anatomical considerations, and cadaveric dissection demonstrates the surgical steps and focuses on important anatomy. Intraoperative images were included to supplement the cadaveric dissection. A retrospective review of adults who had undergone the MOZ approach for nonvascular pathology performed by a single neurosurgeon from 2017 to 2023 was included in this institutional review board\u2013approved study. Descriptive statistics was used to summarize the data. Four representative cases were included to demonstrate the utility of the MOZ approach.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The study included 65 patients (46 female, 19 male), average age 54.84 years, who had undergone transpalpebral MOZ surgery. Presenting symptoms included visual changes (53.8% of cases), vision loss (23.1%), diplopia (21.8%), and proptosis (13.8%). The optic nerve and optic chiasm were involved in 32.3% and 10.8% of cases, respectively. The most common pathology was meningioma (81.5% of cases), and gross-total resection was achieved in 50% of all cases. Major complications included an infection and a carotid injury. Improvement of preoperative symptoms was reported in 92.2% of cases. Visual acuity improved in 12 patients. The mean follow-up was 8.57 \u00b1 8.45 months.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The MOZ approach is safe and durable. The transpalpebral incision provides better cosmesis and functional outcomes than those of standard anterolateral approaches to the skull base. Careful consideration of the limits of the approach is paramount to appropriate application on a case-by-case basis. Further quantitative anatomical studies can help to define and compare the utility of the approach to open cranio-orbital and endoscopic transorbital approaches.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2024.1.focus23875","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T02:17:58Z","timestamp":1711937878000},"page":"E11","source":"Crossref","is-referenced-by-count":4,"title":["Transpalpebral mini-orbitozygomatic approach for nonvascular skull base lesions: a single neurosurgeon\u2019s experience"],"prefix":"10.3171","volume":"56","author":[{"given":"Samon","family":"Tavakoli","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie A.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Feller","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Hun","family":"Hong","sequence":"additional","affiliation":[{"name":"Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan T.","family":"Zwagerman","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"BMJ","first-page":"411","article-title":"On the technique of operations on the central nervous system","volume":"2","author":"Horsley J","year":"1906","unstructured":"Horsley J. On the technique of operations on the central nervous system. BMJ. 1906;2:411\u2013423."},{"issue":"3","key":"b2","series-title":"Arq Neuropsiquiatr","first-page":"430","article-title":"Perspective of the frontolateral craniotomies","volume":"68","author":"Figueiredo EG","year":"2010","unstructured":"Figueiredo EG, Oliveira AM, Plese JP, Teixeira MJ. Perspective of the frontolateral craniotomies. Arq Neuropsiquiatr. 2010;68(3):430\u2013432."},{"key":"b3","series-title":"World Neurosurg","first-page":"77","article-title":"The pterional keyhole craniotomy approach: a historical perspective","volume":"179","author":"Ong V","year":"2023","unstructured":"Ong V, Brown NJ, Pennington Z, The pterional keyhole craniotomy approach: a historical perspective. World Neurosurg. 2023;179:77\u201381."},{"issue":"5","key":"b4","series-title":"Oper Neurosurg (Hagerstown)","first-page":"559","article-title":"The orbitozygomatic craniotomy and its judicious use","volume":"18","author":"Cohen-Gadol A","year":"2020","unstructured":"Cohen-Gadol A. The orbitozygomatic craniotomy and its judicious use. Oper Neurosurg (Hagerstown). 2020;18(5):559\u2013569."},{"issue":"11","key":"b5","series-title":"J Clin Neurosci","first-page":"1545","article-title":"An anatomical analysis of the mini-modified orbitozygomatic and supra-orbital approaches","volume":"19","author":"Figueiredo EG","year":"2012","unstructured":"Figueiredo EG, Deshmukh P, Nakaji P, An anatomical analysis of the mini-modified orbitozygomatic and supra-orbital approaches. J Clin Neurosci. 2012;19(11):1545\u20131550."},{"issue":"6","key":"b6","series-title":"J Neurosurg","first-page":"1020","article-title":"Quantification of increased exposure resulting from orbital rim and orbitozygomatic osteotomy via the frontotemporal transsylvian approach","volume":"91","author":"Schwartz MS","year":"1999","unstructured":"Schwartz MS, Anderson GJ, Horgan MA, Kellogg JX, McMenomey SO, Delashaw JB Jr. Quantification of increased exposure resulting from orbital rim and orbitozygomatic osteotomy via the frontotemporal transsylvian approach. J Neurosurg. 1999;91(6):1020\u20131026."},{"issue":"3-4","key":"b7","series-title":"Acta Neurochir (Wien)","first-page":"79","article-title":"Fronto-temporal approach with orbito-zygomatic removal. Surgical anatomy","volume":"104","author":"Alaywan M","year":"1990","unstructured":"Alaywan M, Sindou M. Fronto-temporal approach with orbito-zygomatic removal. Surgical anatomy. Acta Neurochir (Wien). 1990;104(3-4):79\u201383."},{"issue":"3","key":"b8","series-title":"Neurosurgery","first-page":"550","article-title":"Working area and angle of attack in three cranial base approaches: pterional, orbitozygomatic, and maxillary extension of the orbitozygomatic approach","volume":"50","author":"Gonzalez LF","year":"2002","unstructured":"Gonzalez LF, Crawford NR, Horgan MA, Deshmukh P, Zabramski JM, Spetzler RF. Working area and angle of attack in three cranial base approaches: pterional, orbitozygomatic, and maxillary extension of the orbitozygomatic approach. Neurosurgery. 2002;50(3):550\u2013557."},{"issue":"5","key":"b9","series-title":"Neurosurgery","first-page":"1140","article-title":"Anatomic and clinical study of the orbitopterional approach to anterior communicating artery aneurysms","volume":"52","author":"Andaluz N","year":"2003","unstructured":"Andaluz N, Van Loveren HR, Keller JT, Zuccarello M. Anatomic and clinical study of the orbitopterional approach to anterior communicating artery aneurysms. Neurosurgery. 2003;52(5):1140\u20131149."},{"issue":"6 Suppl Operative","key":"b10","series-title":"Neurosurgery","first-page":"205","article-title":"Quantitative anatomic study of the transciliary supraorbital approach: benefits of additional orbital osteotomy?","volume":"66","author":"Cavalcanti DD","year":"2010","unstructured":"Cavalcanti DD, Garcia-Gonzalez U, Agrawal A, Quantitative anatomic study of the transciliary supraorbital approach: benefits of additional orbital osteotomy? Neurosurgery. 2010;66(6 Suppl Operative):205\u2013210."},{"issue":"4","key":"b11","series-title":"J Neurosurg","first-page":"714","article-title":"Eyebrow incision for combined orbital osteotomy and supraorbital minicraniotomy: application to aneurysms of the anterior circulation","volume":"95","author":"Dare AO","year":"2001","unstructured":"Dare AO, Landi MK, Lopes DK, Grand W. Eyebrow incision for combined orbital osteotomy and supraorbital minicraniotomy: application to aneurysms of the anterior circulation. Technical note. J Neurosurg. 2001;95(4):714\u2013718."},{"key":"b12","series-title":"World Neurosurg","first-page":"49","article-title":"Orbitozygomatic craniotomy with modified Zabramski\u2019s technique: a technical note and anatomic and clinical findings","volume":"97","author":"Kodera T","year":"2017","unstructured":"Kodera T, Arishima H, Yamada S, Orbitozygomatic craniotomy with modified Zabramski\u2019s technique: a technical note and anatomic and clinical findings. World Neurosurg. 2017;97:49\u201357."},{"issue":"5","key":"b13","series-title":"J Neurosurg","first-page":"924","article-title":"Modifications to the orbitozygomatic approach","volume":"99","author":"Lemole GM Jr","year":"2003","unstructured":"Lemole GM Jr, Henn JS, Zabramski JM, Spetzler RF. Modifications to the orbitozygomatic approach. Technical note. J Neurosurg. 2003;99(5):924\u2013930."},{"key":"b14","series-title":"World Neurosurg","first-page":"128","article-title":"Modified orbitozygomatic craniotomy, anterior clinoidectomy, and retrograde suction decompression \"Dallas Technique\" for large unruptured clinoidal-ophthalmic segment aneurysm","volume":"174","author":"Nguyen VN","year":"2023","unstructured":"Nguyen VN, Parikh KA, Wu E, Arthur AS, Michael LM II, Khan NR. Modified orbitozygomatic craniotomy, anterior clinoidectomy, and retrograde suction decompression \"Dallas Technique\" for large unruptured clinoidal-ophthalmic segment aneurysm. World Neurosurg. 2023;174:128."},{"issue":"2","key":"b15","series-title":"Brain Tumor Res Treat","first-page":"58","article-title":"Modified orbitozygomatic approach for resecting a parasellar tumor in a single institution","volume":"9","author":"Kim JG","year":"2021","unstructured":"Kim JG, Lee DH, Kim YI, Kim IS, Sung JH, Yang SH. Modified orbitozygomatic approach for resecting a parasellar tumor in a single institution. Brain Tumor Res Treat. 2021;9(2):58\u201362."},{"issue":"3","key":"b16","series-title":"J Clin Neurosci","first-page":"229","article-title":"Frontotemporal orbitozygomatico-alar approachfor skull surgery","volume":"2","author":"Taguchi Y","year":"1995","unstructured":"Taguchi Y, Yamaguchi Y, Sekino H. Frontotemporal orbitozygomatico-alar approachfor skull surgery. J Clin Neurosci. 1995;2(3):229\u2013234."},{"issue":"3","key":"b17","series-title":"J Korean Neurosurg Soc","first-page":"407","article-title":"Modified orbitozygomatic approach without orbital roof removal for middle fossa lesions","volume":"61","author":"L\u00f3pez-Elizalde R","year":"2018","unstructured":"L\u00f3pez-Elizalde R, Robledo-Moreno E, O Shea-Cuevas G, Matute-Villase\u00f1or E, Campero \u00c1, God\u00ednez-Rub\u00ed M. Modified orbitozygomatic approach without orbital roof removal for middle fossa lesions. J Korean Neurosurg Soc. 2018;61(3):407\u2013414."},{"issue":"7","key":"b18","series-title":"Childs Nerv Syst","first-page":"845","article-title":"Modified osteoplastic orbitozygomatic craniotomy in the pediatric population","volume":"24","author":"Miller ML","year":"2008","unstructured":"Miller ML, Kaufman BA, Lew SM. Modified osteoplastic orbitozygomatic craniotomy in the pediatric population. Childs Nerv Syst. 2008;24(7):845\u2013850."},{"key":"b19","series-title":"World Neurosurg","first-page":"232","article-title":"Transblepharo-preseptal modified orbitozygomatic craniotomy for treatment of ruptured aneurysm: 3-dimensional operative video","volume":"119","author":"Ravina K","year":"2018","unstructured":"Ravina K, Buchanan IA, Wolfswinkel EM, Transblepharo-preseptal modified orbitozygomatic craniotomy for treatment of ruptured aneurysm: 3-dimensional operative video. World Neurosurg. 2018;119:232."},{"key":"b20","series-title":"World Neurosurg","first-page":"6","article-title":"Transblepharo-preseptal modified orbitozygomatic approach for resection of giant frontal cavernous malformation: 3-dimensional operative video","volume":"136","author":"Rutkowski MJ","year":"2020","unstructured":"Rutkowski MJ, Ravina K, Carey JN, Russin JJ. Transblepharo-preseptal modified orbitozygomatic approach for resection of giant frontal cavernous malformation: 3-dimensional operative video. World Neurosurg. 2020;136:6."},{"key":"b21","series-title":"World Neurosurg","first-page":"e335","article-title":"Transblepharo-preseptal modified orbitozygomatic approach for the treatment of ruptured proximal anterior circulation aneurysms","volume":"118","author":"Rennert RC","year":"2018","unstructured":"Rennert RC, Strickland BA, Ravina K, Bakhsheshian J, Carey J, Russin JJ. Transblepharo-preseptal modified orbitozygomatic approach for the treatment of ruptured proximal anterior circulation aneurysms. World Neurosurg. 2018;118:e335\u2013e345."},{"issue":"3","key":"b22","series-title":"J Neurosurg","first-page":"646","article-title":"Quantitative anatomical analysis and clinical experience with mini-pterional and mini-orbitozygomatic approaches for intracranial aneurysm surgery","volume":"127","author":"Yagmurlu K","year":"2017","unstructured":"Yagmurlu K, Safavi-Abbasi S, Belykh E, Quantitative anatomical analysis and clinical experience with mini-pterional and mini-orbitozygomatic approaches for intracranial aneurysm surgery. J Neurosurg. 2017;127(3):646\u2013659."},{"issue":"6","key":"b23","series-title":"Oper Neurosurg (Hagerstown)","first-page":"667","article-title":"The supraorbital eyebrow craniotomy for intra- and extra-axial brain tumors: a single-center series and technique modification","volume":"19","author":"Ansari SF","year":"2020","unstructured":"Ansari SF, Eisenberg A, Rodriguez A, Barkhoudarian G, Kelly DF. The supraorbital eyebrow craniotomy for intra- and extra-axial brain tumors: a single-center series and technique modification. Oper Neurosurg (Hagerstown). 2020;19(6):667\u2013677."},{"issue":"2 Suppl Operative","key":"b24","series-title":"Neurosurgery","first-page":"364","article-title":"Lateral supraorbital approach vs pterional approach: an anatomic qualitative and quantitative evaluation","volume":"68","author":"Salma A","year":"2011","unstructured":"Salma A, Alkandari A, Sammet S, Ammirati M. Lateral supraorbital approach vs pterional approach: an anatomic qualitative and quantitative evaluation. Neurosurgery. 2011;68(2 Suppl Operative):364\u2013372."},{"issue":"1","key":"b25","series-title":"J Neurol Surg B Skull Base","first-page":"105","article-title":"Minipterional approach for middle fossa skull base lesions: technical note","volume":"84","author":"Mura JM","year":"2022","unstructured":"Mura JM, Rabelo NN, Telles JPM, Minipterional approach for middle fossa skull base lesions: technical note. J Neurol Surg B Skull Base. 2022;84(1):105\u2013111."},{"key":"b26","series-title":"World Neurosurg","first-page":"e637","article-title":"Mini-pterional craniotomy for resection of parasellar meningiomas","volume":"117","author":"Tullos HJ","year":"2018","unstructured":"Tullos HJ, Conner AK, Baker CM, Mini-pterional craniotomy for resection of parasellar meningiomas. World Neurosurg. 2018;117:e637-e644."},{"issue":"1","key":"b27","series-title":"J Neurol Surg B Skull Base","first-page":"62","article-title":"The ultimate skull base maneuver does not involve removing bone: quantifying the benefits of the interfascial dissection","volume":"81","author":"Effendi ST","year":"2020","unstructured":"Effendi ST, Momin EN, Basma J, Michael LM, Duckworth EAM. The ultimate skull base maneuver does not involve removing bone: quantifying the benefits of the interfascial dissection. J Neurol Surg B Skull Base. 2020;81(1):62\u201367."},{"issue":"2","key":"b28","series-title":"J Neurosurg","first-page":"297","article-title":"Retrograde dissection of the temporalis muscle preventing muscle atrophy for pterional craniotomy","volume":"84","author":"Oikawa S","year":"1996","unstructured":"Oikawa S, Mizuno M, Muraoka S, Kobayashi S. Retrograde dissection of the temporalis muscle preventing muscle atrophy for pterional craniotomy. Technical note. J Neurosurg. 1996;84(2):297\u2013299."},{"issue":"5","key":"b29","series-title":"J Neurosurg","first-page":"940","article-title":"Modified osteoplastic orbitozygomatic craniotomy","volume":"102","author":"Balasingam V","year":"2005","unstructured":"Balasingam V, Noguchi A, McMenomey SO, Delashaw JB Jr. Modified osteoplastic orbitozygomatic craniotomy. Technical note. J Neurosurg. 2005;102(5):940\u2013944."},{"key":"b30","series-title":"World Neurosurg","first-page":"614","article-title":"A Review of the literature on the transciliary supraorbital keyhole approach","volume":"98","author":"Zumofen DW","year":"2017","unstructured":"Zumofen DW, Rychen J, Roethlisberger M, A Review of the literature on the transciliary supraorbital keyhole approach. World Neurosurg. 2017;98:614\u2013624."},{"issue":"5","key":"b31","series-title":"J Neurosurg","first-page":"892","article-title":"Transciliary subfrontal craniotomy for anterior skull base lesions","volume":"91","author":"S\u00e1nchez-V\u00e1zquez MA","year":"1999","unstructured":"S\u00e1nchez-V\u00e1zquez MA, Barrera-Calatayud P, Mejia-Villela M, Transciliary subfrontal craniotomy for anterior skull base lesions. Technical note. J Neurosurg. 1999;91(5):892\u2013896."},{"key":"b32","series-title":"World Neurosurg","first-page":"e863","article-title":"Anterior skull base tumor resection by transciliary supraorbital keyhole craniotomy: a single institutional experience","volume":"111","author":"Lin YJ","year":"2018","unstructured":"Lin YJ, Chen KT, Lee CC, Anterior skull base tumor resection by transciliary supraorbital keyhole craniotomy: a single institutional experience. World Neurosurg. 2018;111:e863\u2013e870."},{"issue":"5 Suppl 2","key":"b33","series-title":"Neurosurgery","first-page":"324","article-title":"Transciliary orbitofrontozygomatic approach to lesions of the anterior cranial fossa","volume":"64","author":"Warren WL","year":"2009","unstructured":"Warren WL, Grant GA. Transciliary orbitofrontozygomatic approach to lesions of the anterior cranial fossa. Neurosurgery. 2009;64(5 Suppl 2):324\u2013330."},{"key":"b34","series-title":"World Neurosurg","first-page":"e1440","article-title":"Surgical limitations of the microscopic transciliary supraorbital keyhole approach to the anterior and middle skull base","volume":"167","author":"Borghei-Razavi H","year":"2022","unstructured":"Borghei-Razavi H, Eguiluz-Melendez A, Wenping X, Surgical limitations of the microscopic transciliary supraorbital keyhole approach to the anterior and middle skull base. World Neurosurg. 2022;167:e1440\u2013e1447."},{"issue":"4","key":"b35","series-title":"J Neurosurg","first-page":"1187","article-title":"Endoscopic transorbital surgery levels of difficulty","volume":"137","author":"Di Somma A","year":"2022","unstructured":"Di Somma A, Kong DS, de Notaris M, Endoscopic transorbital surgery levels of difficulty. J Neurosurg. 2022;137(4):1187\u20131190."},{"issue":"20","key":"b36","series-title":"J Clin Med","first-page":"6484","article-title":"The transorbital approach, a game-changer in neurosurgery: a guide to safe and reliable surgery based on anatomical principles","volume":"12","author":"de Notaris M","year":"2023","unstructured":"de Notaris M, Sacco M, Corrivetti F, The transorbital approach, a game-changer in neurosurgery: a guide to safe and reliable surgery based on anatomical principles. J Clin Med. 2023;12(20):6484."},{"issue":"1","key":"b37","series-title":"J Neurosurg","first-page":"18","article-title":"Extended endoscopic transorbital approach with superior-lateral orbital rim osteotomy: cadaveric feasibility study and clinical implications (SevEN-007)","volume":"137","author":"Lim J","year":"2021","unstructured":"Lim J, Sung KS, Kim W, Extended endoscopic transorbital approach with superior-lateral orbital rim osteotomy: cadaveric feasibility study and clinical implications (SevEN-007). J Neurosurg. 2021;137(1):18\u201331."},{"issue":"4","key":"b38","series-title":"Oper Neurosurg (Hagerstown)","first-page":"e237","article-title":"Transorbital approach for clipping of anterior communicating artery aneurysm: 2-dimensional operative video","volume":"25","author":"Jean WC","year":"2023","unstructured":"Jean WC, Piper K, Wojcik R, Saez-Alegre M. Transorbital approach for clipping of anterior communicating artery aneurysm: 2-dimensional operative video. Oper Neurosurg (Hagerstown). 2023;25(4):e237."},{"key":"b39","series-title":"World Neurosurg","first-page":"54","article-title":"Endoscopic transorbital surgery: another leap of faith?","volume":"159","author":"Schwartz TH","year":"2022","unstructured":"Schwartz TH, Henderson F Jr, Di Somma A, Endoscopic transorbital surgery: another leap of faith? World Neurosurg. 2022;159:54\u201355."},{"key":"b1","series-title":"BMJ","first-page":"411","article-title":"On the technique of operations on the central nervous system","volume":"2","author":"Horsley J","year":"1906","unstructured":"Horsley J. On the technique of operations on the central nervous system. BMJ. 1906;2:411\u2013423."},{"issue":"3","key":"b2","series-title":"Arq Neuropsiquiatr","first-page":"430","article-title":"Perspective of the frontolateral craniotomies","volume":"68","author":"Figueiredo EG","year":"2010","unstructured":"Figueiredo EG, Oliveira AM, Plese JP, Teixeira MJ. Perspective of the frontolateral craniotomies. Arq Neuropsiquiatr. 2010;68(3):430\u2013432."},{"key":"b3","series-title":"World Neurosurg","first-page":"77","article-title":"The pterional keyhole craniotomy approach: a historical perspective","volume":"179","author":"Ong V","year":"2023","unstructured":"Ong V, Brown NJ, Pennington Z, The pterional keyhole craniotomy approach: a historical perspective. World Neurosurg. 2023;179:77\u201381."},{"issue":"5","key":"b4","series-title":"Oper Neurosurg (Hagerstown)","first-page":"559","article-title":"The orbitozygomatic craniotomy and its judicious use","volume":"18","author":"Cohen-Gadol A","year":"2020","unstructured":"Cohen-Gadol A. The orbitozygomatic craniotomy and its judicious use. Oper Neurosurg (Hagerstown). 2020;18(5):559\u2013569."},{"issue":"11","key":"b5","series-title":"J Clin Neurosci","first-page":"1545","article-title":"An anatomical analysis of the mini-modified orbitozygomatic and supra-orbital approaches","volume":"19","author":"Figueiredo EG","year":"2012","unstructured":"Figueiredo EG, Deshmukh P, Nakaji P, An anatomical analysis of the mini-modified orbitozygomatic and supra-orbital approaches. J Clin Neurosci. 2012;19(11):1545\u20131550."},{"issue":"6","key":"b6","series-title":"J Neurosurg","first-page":"1020","article-title":"Quantification of increased exposure resulting from orbital rim and orbitozygomatic osteotomy via the frontotemporal transsylvian approach","volume":"91","author":"Schwartz MS","year":"1999","unstructured":"Schwartz MS, Anderson GJ, Horgan MA, Kellogg JX, McMenomey SO, Delashaw JB Jr. Quantification of increased exposure resulting from orbital rim and orbitozygomatic osteotomy via the frontotemporal transsylvian approach. J Neurosurg. 1999;91(6):1020\u20131026."},{"issue":"3-4","key":"b7","series-title":"Acta Neurochir (Wien)","first-page":"79","article-title":"Fronto-temporal approach with orbito-zygomatic removal. Surgical anatomy","volume":"104","author":"Alaywan M","year":"1990","unstructured":"Alaywan M, Sindou M. Fronto-temporal approach with orbito-zygomatic removal. Surgical anatomy. Acta Neurochir (Wien). 1990;104(3-4):79\u201383."},{"issue":"3","key":"b8","series-title":"Neurosurgery","first-page":"550","article-title":"Working area and angle of attack in three cranial base approaches: pterional, orbitozygomatic, and maxillary extension of the orbitozygomatic approach","volume":"50","author":"Gonzalez LF","year":"2002","unstructured":"Gonzalez LF, Crawford NR, Horgan MA, Deshmukh P, Zabramski JM, Spetzler RF. Working area and angle of attack in three cranial base approaches: pterional, orbitozygomatic, and maxillary extension of the orbitozygomatic approach. Neurosurgery. 2002;50(3):550\u2013557."},{"issue":"5","key":"b9","series-title":"Neurosurgery","first-page":"1140","article-title":"Anatomic and clinical study of the orbitopterional approach to anterior communicating artery aneurysms","volume":"52","author":"Andaluz N","year":"2003","unstructured":"Andaluz N, Van Loveren HR, Keller JT, Zuccarello M. Anatomic and clinical study of the orbitopterional approach to anterior communicating artery aneurysms. Neurosurgery. 2003;52(5):1140\u20131149."},{"issue":"6 Suppl Operative","key":"b10","series-title":"Neurosurgery","first-page":"205","article-title":"Quantitative anatomic study of the transciliary supraorbital approach: benefits of additional orbital osteotomy?","volume":"66","author":"Cavalcanti DD","year":"2010","unstructured":"Cavalcanti DD, Garcia-Gonzalez U, Agrawal A, Quantitative anatomic study of the transciliary supraorbital approach: benefits of additional orbital osteotomy? Neurosurgery. 2010;66(6 Suppl Operative):205\u2013210."},{"issue":"4","key":"b11","series-title":"J Neurosurg","first-page":"714","article-title":"Eyebrow incision for combined orbital osteotomy and supraorbital minicraniotomy: application to aneurysms of the anterior circulation","volume":"95","author":"Dare AO","year":"2001","unstructured":"Dare AO, Landi MK, Lopes DK, Grand W. Eyebrow incision for combined orbital osteotomy and supraorbital minicraniotomy: application to aneurysms of the anterior circulation. Technical note. J Neurosurg. 2001;95(4):714\u2013718."},{"key":"b12","series-title":"World Neurosurg","first-page":"49","article-title":"Orbitozygomatic craniotomy with modified Zabramski\u2019s technique: a technical note and anatomic and clinical findings","volume":"97","author":"Kodera T","year":"2017","unstructured":"Kodera T, Arishima H, Yamada S, Orbitozygomatic craniotomy with modified Zabramski\u2019s technique: a technical note and anatomic and clinical findings. World Neurosurg. 2017;97:49\u201357."},{"issue":"5","key":"b13","series-title":"J Neurosurg","first-page":"924","article-title":"Modifications to the orbitozygomatic approach","volume":"99","author":"Lemole GM Jr","year":"2003","unstructured":"Lemole GM Jr, Henn JS, Zabramski JM, Spetzler RF. Modifications to the orbitozygomatic approach. Technical note. J Neurosurg. 2003;99(5):924\u2013930."},{"key":"b14","series-title":"World Neurosurg","first-page":"128","article-title":"Modified orbitozygomatic craniotomy, anterior clinoidectomy, and retrograde suction decompression \"Dallas Technique\" for large unruptured clinoidal-ophthalmic segment aneurysm","volume":"174","author":"Nguyen VN","year":"2023","unstructured":"Nguyen VN, Parikh KA, Wu E, Arthur AS, Michael LM II, Khan NR. Modified orbitozygomatic craniotomy, anterior clinoidectomy, and retrograde suction decompression \"Dallas Technique\" for large unruptured clinoidal-ophthalmic segment aneurysm. World Neurosurg. 2023;174:128."},{"issue":"2","key":"b15","series-title":"Brain Tumor Res Treat","first-page":"58","article-title":"Modified orbitozygomatic approach for resecting a parasellar tumor in a single institution","volume":"9","author":"Kim JG","year":"2021","unstructured":"Kim JG, Lee DH, Kim YI, Kim IS, Sung JH, Yang SH. Modified orbitozygomatic approach for resecting a parasellar tumor in a single institution. Brain Tumor Res Treat. 2021;9(2):58\u201362."},{"issue":"3","key":"b16","series-title":"J Clin Neurosci","first-page":"229","article-title":"Frontotemporal orbitozygomatico-alar approachfor skull surgery","volume":"2","author":"Taguchi Y","year":"1995","unstructured":"Taguchi Y, Yamaguchi Y, Sekino H. Frontotemporal orbitozygomatico-alar approachfor skull surgery. J Clin Neurosci. 1995;2(3):229\u2013234."},{"issue":"3","key":"b17","series-title":"J Korean Neurosurg Soc","first-page":"407","article-title":"Modified orbitozygomatic approach without orbital roof removal for middle fossa lesions","volume":"61","author":"L\u00f3pez-Elizalde R","year":"2018","unstructured":"L\u00f3pez-Elizalde R, Robledo-Moreno E, O Shea-Cuevas G, Matute-Villase\u00f1or E, Campero \u00c1, God\u00ednez-Rub\u00ed M. Modified orbitozygomatic approach without orbital roof removal for middle fossa lesions. J Korean Neurosurg Soc. 2018;61(3):407\u2013414."},{"issue":"7","key":"b18","series-title":"Childs Nerv Syst","first-page":"845","article-title":"Modified osteoplastic orbitozygomatic craniotomy in the pediatric population","volume":"24","author":"Miller ML","year":"2008","unstructured":"Miller ML, Kaufman BA, Lew SM. Modified osteoplastic orbitozygomatic craniotomy in the pediatric population. Childs Nerv Syst. 2008;24(7):845\u2013850."},{"key":"b19","series-title":"World Neurosurg","first-page":"232","article-title":"Transblepharo-preseptal modified orbitozygomatic craniotomy for treatment of ruptured aneurysm: 3-dimensional operative video","volume":"119","author":"Ravina K","year":"2018","unstructured":"Ravina K, Buchanan IA, Wolfswinkel EM, Transblepharo-preseptal modified orbitozygomatic craniotomy for treatment of ruptured aneurysm: 3-dimensional operative video. World Neurosurg. 2018;119:232."},{"key":"b20","series-title":"World Neurosurg","first-page":"6","article-title":"Transblepharo-preseptal modified orbitozygomatic approach for resection of giant frontal cavernous malformation: 3-dimensional operative video","volume":"136","author":"Rutkowski MJ","year":"2020","unstructured":"Rutkowski MJ, Ravina K, Carey JN, Russin JJ. Transblepharo-preseptal modified orbitozygomatic approach for resection of giant frontal cavernous malformation: 3-dimensional operative video. World Neurosurg. 2020;136:6."},{"key":"b21","series-title":"World Neurosurg","first-page":"e335","article-title":"Transblepharo-preseptal modified orbitozygomatic approach for the treatment of ruptured proximal anterior circulation aneurysms","volume":"118","author":"Rennert RC","year":"2018","unstructured":"Rennert RC, Strickland BA, Ravina K, Bakhsheshian J, Carey J, Russin JJ. Transblepharo-preseptal modified orbitozygomatic approach for the treatment of ruptured proximal anterior circulation aneurysms. World Neurosurg. 2018;118:e335\u2013e345."},{"issue":"3","key":"b22","series-title":"J Neurosurg","first-page":"646","article-title":"Quantitative anatomical analysis and clinical experience with mini-pterional and mini-orbitozygomatic approaches for intracranial aneurysm surgery","volume":"127","author":"Yagmurlu K","year":"2017","unstructured":"Yagmurlu K, Safavi-Abbasi S, Belykh E, Quantitative anatomical analysis and clinical experience with mini-pterional and mini-orbitozygomatic approaches for intracranial aneurysm surgery. J Neurosurg. 2017;127(3):646\u2013659."},{"issue":"6","key":"b23","series-title":"Oper Neurosurg (Hagerstown)","first-page":"667","article-title":"The supraorbital eyebrow craniotomy for intra- and extra-axial brain tumors: a single-center series and technique modification","volume":"19","author":"Ansari SF","year":"2020","unstructured":"Ansari SF, Eisenberg A, Rodriguez A, Barkhoudarian G, Kelly DF. The supraorbital eyebrow craniotomy for intra- and extra-axial brain tumors: a single-center series and technique modification. Oper Neurosurg (Hagerstown). 2020;19(6):667\u2013677."},{"issue":"2 Suppl Operative","key":"b24","series-title":"Neurosurgery","first-page":"364","article-title":"Lateral supraorbital approach vs pterional approach: an anatomic qualitative and quantitative evaluation","volume":"68","author":"Salma A","year":"2011","unstructured":"Salma A, Alkandari A, Sammet S, Ammirati M. Lateral supraorbital approach vs pterional approach: an anatomic qualitative and quantitative evaluation. Neurosurgery. 2011;68(2 Suppl Operative):364\u2013372."},{"issue":"1","key":"b25","series-title":"J Neurol Surg B Skull Base","first-page":"105","article-title":"Minipterional approach for middle fossa skull base lesions: technical note","volume":"84","author":"Mura JM","year":"2022","unstructured":"Mura JM, Rabelo NN, Telles JPM, Minipterional approach for middle fossa skull base lesions: technical note. J Neurol Surg B Skull Base. 2022;84(1):105\u2013111."},{"key":"b26","series-title":"World Neurosurg","first-page":"e637","article-title":"Mini-pterional craniotomy for resection of parasellar meningiomas","volume":"117","author":"Tullos HJ","year":"2018","unstructured":"Tullos HJ, Conner AK, Baker CM, Mini-pterional craniotomy for resection of parasellar meningiomas. World Neurosurg. 2018;117:e637-e644."},{"issue":"1","key":"b27","series-title":"J Neurol Surg B Skull Base","first-page":"62","article-title":"The ultimate skull base maneuver does not involve removing bone: quantifying the benefits of the interfascial dissection","volume":"81","author":"Effendi ST","year":"2020","unstructured":"Effendi ST, Momin EN, Basma J, Michael LM, Duckworth EAM. The ultimate skull base maneuver does not involve removing bone: quantifying the benefits of the interfascial dissection. J Neurol Surg B Skull Base. 2020;81(1):62\u201367."},{"issue":"2","key":"b28","series-title":"J Neurosurg","first-page":"297","article-title":"Retrograde dissection of the temporalis muscle preventing muscle atrophy for pterional craniotomy","volume":"84","author":"Oikawa S","year":"1996","unstructured":"Oikawa S, Mizuno M, Muraoka S, Kobayashi S. Retrograde dissection of the temporalis muscle preventing muscle atrophy for pterional craniotomy. Technical note. J Neurosurg. 1996;84(2):297\u2013299."},{"issue":"5","key":"b29","series-title":"J Neurosurg","first-page":"940","article-title":"Modified osteoplastic orbitozygomatic craniotomy","volume":"102","author":"Balasingam V","year":"2005","unstructured":"Balasingam V, Noguchi A, McMenomey SO, Delashaw JB Jr. Modified osteoplastic orbitozygomatic craniotomy. Technical note. J Neurosurg. 2005;102(5):940\u2013944."},{"key":"b30","series-title":"World Neurosurg","first-page":"614","article-title":"A Review of the literature on the transciliary supraorbital keyhole approach","volume":"98","author":"Zumofen DW","year":"2017","unstructured":"Zumofen DW, Rychen J, Roethlisberger M, A Review of the literature on the transciliary supraorbital keyhole approach. World Neurosurg. 2017;98:614\u2013624."},{"issue":"5","key":"b31","series-title":"J Neurosurg","first-page":"892","article-title":"Transciliary subfrontal craniotomy for anterior skull base lesions","volume":"91","author":"S\u00e1nchez-V\u00e1zquez MA","year":"1999","unstructured":"S\u00e1nchez-V\u00e1zquez MA, Barrera-Calatayud P, Mejia-Villela M, Transciliary subfrontal craniotomy for anterior skull base lesions. Technical note. J Neurosurg. 1999;91(5):892\u2013896."},{"key":"b32","series-title":"World Neurosurg","first-page":"e863","article-title":"Anterior skull base tumor resection by transciliary supraorbital keyhole craniotomy: a single institutional experience","volume":"111","author":"Lin YJ","year":"2018","unstructured":"Lin YJ, Chen KT, Lee CC, Anterior skull base tumor resection by transciliary supraorbital keyhole craniotomy: a single institutional experience. World Neurosurg. 2018;111:e863\u2013e870."},{"issue":"5 Suppl 2","key":"b33","series-title":"Neurosurgery","first-page":"324","article-title":"Transciliary orbitofrontozygomatic approach to lesions of the anterior cranial fossa","volume":"64","author":"Warren WL","year":"2009","unstructured":"Warren WL, Grant GA. Transciliary orbitofrontozygomatic approach to lesions of the anterior cranial fossa. Neurosurgery. 2009;64(5 Suppl 2):324\u2013330."},{"key":"b34","series-title":"World Neurosurg","first-page":"e1440","article-title":"Surgical limitations of the microscopic transciliary supraorbital keyhole approach to the anterior and middle skull base","volume":"167","author":"Borghei-Razavi H","year":"2022","unstructured":"Borghei-Razavi H, Eguiluz-Melendez A, Wenping X, Surgical limitations of the microscopic transciliary supraorbital keyhole approach to the anterior and middle skull base. World Neurosurg. 2022;167:e1440\u2013e1447."},{"issue":"4","key":"b35","series-title":"J Neurosurg","first-page":"1187","article-title":"Endoscopic transorbital surgery levels of difficulty","volume":"137","author":"Di Somma A","year":"2022","unstructured":"Di Somma A, Kong DS, de Notaris M, Endoscopic transorbital surgery levels of difficulty. J Neurosurg. 2022;137(4):1187\u20131190."},{"issue":"20","key":"b36","series-title":"J Clin Med","first-page":"6484","article-title":"The transorbital approach, a game-changer in neurosurgery: a guide to safe and reliable surgery based on anatomical principles","volume":"12","author":"de Notaris M","year":"2023","unstructured":"de Notaris M, Sacco M, Corrivetti F, The transorbital approach, a game-changer in neurosurgery: a guide to safe and reliable surgery based on anatomical principles. J Clin Med. 2023;12(20):6484."},{"issue":"1","key":"b37","series-title":"J Neurosurg","first-page":"18","article-title":"Extended endoscopic transorbital approach with superior-lateral orbital rim osteotomy: cadaveric feasibility study and clinical implications (SevEN-007)","volume":"137","author":"Lim J","year":"2021","unstructured":"Lim J, Sung KS, Kim W, Extended endoscopic transorbital approach with superior-lateral orbital rim osteotomy: cadaveric feasibility study and clinical implications (SevEN-007). J Neurosurg. 2021;137(1):18\u201331."},{"issue":"4","key":"b38","series-title":"Oper Neurosurg (Hagerstown)","first-page":"e237","article-title":"Transorbital approach for clipping of anterior communicating artery aneurysm: 2-dimensional operative video","volume":"25","author":"Jean WC","year":"2023","unstructured":"Jean WC, Piper K, Wojcik R, Saez-Alegre M. Transorbital approach for clipping of anterior communicating artery aneurysm: 2-dimensional operative video. Oper Neurosurg (Hagerstown). 2023;25(4):e237."},{"key":"b39","series-title":"World Neurosurg","first-page":"54","article-title":"Endoscopic transorbital surgery: another leap of faith?","volume":"159","author":"Schwartz TH","year":"2022","unstructured":"Schwartz TH, Henderson F Jr, Di Somma A, Endoscopic transorbital surgery: another leap of faith? World Neurosurg. 2022;159:54\u201355."}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/56\/4\/article-pE11.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/56\/4\/article-pE11.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/56\/4\/article-pE11.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:50:00Z","timestamp":1780131000000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/56\/4\/article-pE11.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":78,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2024.1.focus23875","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}