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.
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.
An epidural dissection between these points are made.
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.
After the bone flap is removed, the brain is freed from the anterior and middle fossa in the epidural plane.
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.
