Abstract

AIM: To describes a novel surgery to access the anterior cranial fossa through the roof of the orbit.
case report: a 27 year old patient with rhino cerebral mucormycosis with a brain abscess in the anterior cranial fossa was treated by drainage of the abscess though the novel approach instead of an open craniotomy. Under GA, through a superior lid crease incision, the roof of the orbit was exposed and the frontal bone was drilled to make a small keyhole entry. through this keyhole , the unhealthy dura mater was incised to drain the brain abscess, amphotericin lavage was done and the defect in closed with fascia lata. patient was continued on systemic antifungals. no complication was noted and patient is doing well after 2 years
conclusion: The orbital access through TONES is a novel multidisciplinary approach in select neurosurgical cases with minimal morbidity, early recovery time and with greater applications in future.