Orbitozygomatic approach for excisions of orbital tumors with 1 piece of craniotomy bone flap: 2 case reports

Background: Orbital tumors are classified as primary and secondary. For primary entities, there are variable pathologies with benign and malignant natures. Many of the orbital tumors should be excised through neurosurgical approaches. We reported 2 cases of orbital tumors, which were clearly disclosed by magnetic resonance imaging. Case Description: Case 1 was a 70-year-old woman and case 2 was a 57-year-old woman. Both cases were presented with progressive unilateral proptosis. The pathologies were intraorbital cavernous hemangioma and lacrimal mixed adenoma, respectively. With the scalp incision all posterior to the hairline, frontotemporal orbitozygomatic approach with 1 piece of craniotomy bone flap was performed after freeing all the remaining periorbita and other soft tissue attachments. This approach assures maximum exposure for successful en bloc excisions of these tumors with minimal bone loss, so the cosmetic results are satisfactory. Conclusions: Even though most orbital tumors are diagnosed by ophthalmologists, most of them should be operated on by neurosurgeons because neurosurgical approaches offer wide and safe surgical windows.