Skull Base 2001; 11(4): 233-240
DOI: 10.1055/s-2001-18629
ORIGINAL ARTICLES

Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Anteromedial Approach to the Orbit

Haluk Deda1 , Hasan Çaglar Ugur1 , Irfan Yorulmaz2 , Babur Kucuk2
  • 1Department of Neurosurgery, School of Medicine, Ankara University, Ankara, Turkey
  • 2Department of ENT, School of Medicine, Ankara University, Ankara, Turkey
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Publikationsverlauf

Publikationsdatum:
28. November 2001 (online)

ABSTRACT

This study evaluated the surgical results of the anteromedial approach for treatment of orbital lesions in 16 patients. Pre- and postoperatively, all patients underwent a complete physical examination focusing on the head and neck area including a thorough ophthalmologic evaluation, computerized tomography, and magnetic resonance imaging. The surgical approach was limited to a medial orbitotomy in five patients; the remaining 11 patients underwent a medial orbitotomy combined with an external sphenoethmoidectomy. The tumor was removed completely without damaging the intraorbital neurovascular structures in all but one patient whose recurrent clival chordoma extended beyond the limits of an extracranial approach. Fibro-osseous lesions, cavernous hemangiomas, and dermoid cysts were the most common pathologies. The follow-up ranged from 18 to 48 months, and no patient has shown evidence of a recurrence. One patient with a clival chordoma received radiation therapy. The lateral nasal skin incision healed with acceptable cosmetic results. The anteromedial approach to the orbit provides a wider working space and direct exposure while protecting neurovascular structures.

REFERENCES

  • 1 Johnson L N, Krohel G B, Yeon E B, Parnes S M. Sinus tumors invading the orbit.  Ophtalmology . 1984;  91(3) 209-217
  • 2 Kennerdell J S, Maroon J C. Microsurgical approach to intraorbital tumors.  Arch Ophthalmol . 1976;  94 1333-1335
  • 3 Leatherbarrow B, Noble J L, Lloyd I C. Cavernous hemangioma of the orbit.  Eye . 1989;  3 90-99
  • 4 Ciapetta P, Delfini R, Ianetti G, Salvati M, Raco A. Surgical strategies in the treatment of symptomatic osteomas of the orbital walls.  Neurosurgery . 1992;  31(4) 628-632
  • 5 Delfini R, Missori P, Iannetti G, Ciappetta P, Cantore G. Mucoceles of the paranasal sinuses with intracranial and intraorbital extension: report of 28 cases.  Neurosurgery . 1993;  32(6) 901-906
  • 6 Ducasse A, Delattre J F, Segal A, Desphieux J L, Flament J B. Anatomical basis of the surgical approach to the medial wall of the orbit.  Anat Clin . 1985;  7 15-21
  • 7 Maroon J C, Kennerdell J S. Surgical approaches to the orbit: indications and techniques.  J Neurosurg . 1984;  60 1226-1235
  • 8 Osguthorpe J D. Surgical access to primary orbital tumors.  Otolaringol Clin North Am . 1988;  21(1) 135-152
  • 9 Rubin J S, Lund V J, Salmon B. Frontoethmoidectomy in the treatment of mucoceles.  Arc Otolaryngol Head Neck Surg . 1986;  112 434-436
  • 10 Smith B, Lisman R D, Baker D. Eyelid and orbital treatment following radical maxillotomy.  Ophthalmology . 1984;  91(3) 218-228
  • 11 Weaver D T, Bartley G B. Malignant neoplasia of the paranasal sinuses associated with mucocele.  Ophthalmology . 1991;  98(3) 342-346
  • 12 Leone C R. Surgical approach to the medial retrobulbar space.  AJO . 1983;  96 1-5
  • 13 Leone C R, Wissinger J P. Surgical approaches to disease of the orbital apex.  Ophthalmology . 1988;  95(3) 391-397
  • 14 McKenzie J D, Burton P D. Computed tomography (CT) and magnetic resonance (MR) imaging of the orbits.  BNI Q . 1993;  9(2) 35-45
  • 15 Osguthorpe J D, Saunders R A, Adkins W Y, Charleston S C. Evaluation of and access to posterior orbital tumors.  Laryngoscope . 1983;  93 766-771
  • 16 Hejazi N, Hassler W. The transconjunctival microsurgical approach to the orbit: recent experience in 22 cases.  Plast Reconstr Surg . 1999;  103(4) 1124-1128
  • 17 Mullins J B, Holds J B, Branham G H, Thomas J R. Complications of the transconjunctival approach: a review of 400 cases.  Arch Otolaryngol Head Neck Surg . 1997;  123(4) 385-388