The frontal-zygomatic approach vs. the anterior approach for orbital tumor surgery: a retrospective review of the indications and outcomes

Purpose: The orbit, a major esthetic constituent of the face, is important in our social lives. Therefore, a careful approach is required for orbital tumor surgery, during both radical treatment and biopsy. To achieve a wider operative field, we developed a frontal-zygomatic (FZ) approach, in which bone of the superior or inferior wall is resected en block. Methods: The subjects consisted of 42 patients for whom a diagnosis of orbital tumor was made by preoperative diagnostic imaging and histopathological examination. Tumor resection was performed in 16 patients and tumor biopsy in 26. Following the adoption of the FZ approach for surgical intervention, we evaluated the postoperative complications and classified them into one of four categories: diplopia, enopthalmos, paralysis, or scar formation. Results: In all patients, a definite diagnosis was made by surgical intervention, showing that tumor resection and biopsy were useful. Conclusions: Because the FZ approach caused no significant postoperative complications and produced excellent results, we believe that this approach should be followed in most cases other than tumors centering on the orbital apex or extending into the optic canal.