**4. Transorbital approaches**

Transorbital approaches, due to the inclusion of the upper wall of the orbit in the bone flap, increase the free space for working with microinstruments, significantly reduce the distance to the target of surgery, and reduce brain retraction. This made it possible to expand indications in aneurysm surgery, for example, to use this approach for large and giant aneurysms, small unruptured basilar aneurysms. The main modifications of transorbital approaches include:

#### **Figure 17.** *Various types of skin incisions for transorbital craniotomy. A - eyebrow (blue), B - transpalpebral (red).*


Despite different types of skin incisions, the stage of osteotomy is identical, but the functional and cosmetic outcomes are significantly different (**Figure 17**).
