Frontal orbital approaches to sellar and parasellar tumors

Surgical access to lesions in and around the sella require a short working distance and minimum of brain retraction, considering that the work will be performed around the pituitary stalk, optic chiasm, carotid artery and its branches. These difficulties led the neurosurgeon to use a great number of surgical approaches. Among them, the orbital zygomatic and the lateral subfrontal approaches are the most suitable procedures. In the last two years, 26 tumors were approached by this route. They consisted of 14 pituitary tumors, 5 craniopharyingiomas, 2 chordomas, 2 optic nerve gliomas and 3 tuberculum sellae meningeomas. The final result was total removal in 19 cases and 2 post operative mortalities. Although the subfrontal lateral approach is not a new technique, it proves to be a more effective way to reach this site.