Anatomy of and Surgical Approaches to the Orbit for Neurosurgeons

Orbital surgery falls under the purview of neurosurgeons and ophthalmologists. Transcranial, transorbital, and endonasal approaches can be used to access lesions of the orbit. Selection of the most appropriate approach hinges on the location of the pathology, patient-specific anatomical variations, and the pathology of the treated lesion, as well as surgeon preference and comfort. Familiarity with the variety of approaches and close collaboration between specialties allow the use of the full repertoire of available approaches to all regions of the orbit as well as flexibility when exploring management options. This chapter will detail the critical orbital anatomy for the neurosurgeon and review the gamut of transcranial, transorbital, and endonasal approaches to orbit.