Objective To investigate the indications,approaches,and essentials of cranio-orbital surgeries for orbital tumors.Methods Fifty-five orbital tumors treated by refined transcranial orbitotomy through superolateral approaches,from 2003 to 2011,were reviewed.Thirty-nine tumors were excised with orbitopterional approaches,while 16 were excised with orbitofrontal approaches,orbitozygomatic approaches,or zygomatic-pterional approaches.Results Of the 55 orbital tumors,38 (69.1％) were totally resected,7 (12.7％) were subtotally resected,and 7 (12.7％) were partly resected.The other 3 (5.5％)took biopsies.The optic functions improved or retained in 45 (81.8％) patients.Nine (16.4％) patients suffered from eye-moving disfunctions or visual-acuity declines,and 1 (1.8％) patient suffered from hemiparalysis.Conclusions Tumors in the posterior and apex part of the orbit,or tumors extended from the orbit to the cranial,can be well treated through transcranial approaches.Appropriate methods may help to bring maximum convenience to exposure and excision of the lesions,and to conserve the functions.Unnecessary injuries could be avoided as well.