Figure 5.

Pterional approach. Preoperative T1-weighted axial (A) and coronal (B) gadolinium-enhanced MRI of a patient with a heterogeneously enhancing lesion of the left orbital apex causing compression of the optic nerve and nerves exiting the superior orbital fissure. The location and larger size of the lesion requires a pterional cranio-orbital approach by a multidisciplinary team to remove the sphenoid wing and expose the superior and lateral aspects of the orbit and orbital apex. Postoperative T1-weighted axial (C) and coronal (D) gadolinium-enhanced MRI demonstrate complete resection of this lesion associated with resolution of symptoms.