Authors of section

Authors

Brian Burkey, Neal Futran

Executive Editors

Gregorio Sánchez Aniceto, Marcelo Figari

General Editor

Daniel Buchbinder

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Access osteotomy - Frontal craniotomy

1. Introduction

Frontal craniotomy gives access to the:

  • anterior cranial fossa
  • orbital roof on both sides
  • anterior portion of the optic chiasm

The coronal approach is used to expose the frontal bone.

access osteotomy   frontal craniotomy

2. Craniotomy

After the exposure of the frontal bone and the orbits, burr holes are placed at the vertex and nasal frontal region as well as in both temporal regions.

access osteotomy   frontal craniotomy

An epidural dissection between these points are made.

access osteotomy   frontal craniotomy

A bifrontal craniotomy beginning 1 cm above the superior orbital rim and extending to behind the coronal suture is completed by the neurosurgeon, using a craniotome.

access osteotomy   frontal craniotomy

After the bone flap is removed, the brain is freed from the anterior and middle fossa in the epidural plane.

access osteotomy   frontal craniotomy

3. Replacement of the frontal craniotomy bone

The frontal craniotomy bone is replaced and fixated in the standard fashion. Care is taken as so to secure that adequate space is left between the frontal bone flap and the supraorbital rim so as not to compress any flap.

access osteotomy   frontal craniotomy