The authors describe a surgical incision and technique for lateral orbitotomy that is intended to minimize visible scarring and deformity.
This is a noncomparative, interventional, retrospective case series. Other surgical approaches for lateral orbitotomy are briefly reviewed. The authors' technique includes incision placement within the natural upper eyelid crease, with minimal extension in a relaxed skin tension line; dissection to the superior and lateral orbital rims in the submuscular plane; and wide dissection within the subperiosteal space. Criteria are described for inclusion of a bone flap in the technique.
The eyelid crease incision has been used for exposure of the superolateral diagonal half of the orbit in approximately 600 cases. A variety of pathologic conditions affecting the orbital bones or the subperiosteal, extraconal, or intraconal spaces have been treated. Surgical exposure has been adequate to achieve the goals of surgery in individual cases, and the cosmetic results have been preferable to those the authors achieved using other surgical incisions.
The eyelid crease incision for lateral orbitotomy allows dissection in relatively avascular planes, involves minimal transection of orbicularis muscle and lymphatic channels, and results in negligible postoperative scarring. Depending on the size and location of the lesion and the goal of surgery, the eyelid crease incision may be used without a bone flap. However, when a bone flap is needed, the incision does not restrict its size.
©1999The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc.