Supraorbital craniotomy by fracture of the anterior orbital roof. Technical note.

The authors describe a new and rapid method to safely perform a supraorbital craniotomy. This technique can be used when tumor does not invade the orbital roof. Previous descriptions of the supraorbital craniotomy involved exposure of the frontal sinus by removing its anterior wall and using the Gigli saw to separate the orbital roof. This new approach avoids removal of the anterior sinus wall and separates the supraorbital bone flap from the calvaria by fracturing the anterior orbital roof forward. In addition, a method for harvesting a laterally based pericranium and muscle pedicle that contains a section of contralateral temporalis muscle is described. This vascularized pedicle can be used for repair of cerebrospinal fluid leaks or bone defects along the anterior fossa floor and orbit.