Skull Base 2010; 20(4): 237-244
DOI: 10.1055/s-0030-1249247

© Thieme Medical Publishers

Transpalpebral Orbitofrontal Craniotomy: A Minimally Invasive Approach to Anterior Cranial Vault Lesions

Kofi D. Owusu Boahene1 , 4 , Michael Lim2 , 4 , Eugene Chu1 , 5 , Alfredo Quinones-Hinojosa3 , 4
  • 1Department of Otolaryngology Head and Neck Surgery, Baltimore, Maryland
  • 2Department of Neurosurgery and Oncology, Baltimore, Maryland
  • 3Department of Neurosurgery and Neuroscience, Baltimore, Maryland
  • 4The Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 5University of California at Irvine, Orange, California
Further Information

Publication History

Publication Date:
01 March 2010 (online)


To describe a minimally invasive approach to anterior cranial vault pathology using a transpalpebral exposure with a miniorbitofrontal craniotomy. Design: Case series. Setting: Tertiary referral hospital with multidisciplinary skull base program. Participants include patients with intra-axial and extra-axial anterior skull base lesions who underwent the transpalpebral minicraniotomy approach. Main Outcome measures: Feasibility of the approach to permit adequate exposure of targeted lesion. We applied this approach in seven patients for the repair of persistent cerebrospinal fluid leaks, pneumocephalus, and the biopsy or resection of midline brain tumors along the anterior cranial base. The approach allowed bimanual instrumentation working with either endoscopic or microscopic visualization for tumor resection and repair of dural and cranial base defects. We measured an average working distance of 4 cm to the sella. The transpalpebral miniorbitofrontal craniotomy approach to the anterior cranial base is quick, adequate, and safe and should be considered as an alternative to extended bifrontal approaches and/or pterional craniotomies for select anterior cranial vault pathology.


Kofi D. Owusu Boahene, M.D. 

Department of Otolaryngology Head and Neck Surgery, The Johns Hopkins University School of Medicine

601 N. Caroline Street, Johns Hopkins Outpatient Center, 6th Floor, Baltimore, MD 21287