Lateral Transorbital Surgery: The Neurosurgeon’s Perspective

Although there are four quadrants to the transorbital approach, the lateral transorbital approach (LTOA) is the most familiar and useful to the neurosurgeon. The LTOA provides minimal access to areas of the skull base that are not accessible endonasally, including the medial sphenoid wing, anterior clinoid, middle fossa and lateral cavernous sinus, and Meckel’s cave. The instrumentation required for the two approaches is quite similar, but there are also several important philosophical differences. In this chapter, we highlight those differences and provide an illustration of the seven skull base targets accessible with the LTOA.