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JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
Transcaruncular approach to the medial orbit and orbital apex.
Ophthalmology 2000 August
OBJECTIVE: To present a versatile approach to the medial orbit and orbital apex through the caruncle.
DESIGN: Retrospective, noncomparative, case series with description of surgical technique.
PARTICIPANTS: Twenty-five consecutive patients underwent orbital surgery by use of a transcaruncular approach.
INTERVENTION: Inferior and medial wall fracture repair or orbital decompression by means of a transcaruncular or combined transfornix-transcaruncular approach.
MAIN OUTCOME MEASURES: The surgical indications and complications were recorded for each patient.
RESULTS: Ten patients (10 orbits) underwent combined inferior and medial orbital wall fracture repair through a combined transfornix-transcaruncular approach. In 8 of 10 (80%) orbits, the inferior oblique muscle was disinserted during surgery. Fifteen patients (24 orbits) underwent orbital decompression surgery for dysthyroid orbitopathy. An isolated transcaruncular approach was used in 5 of 24 orbits, and a combined transfornix-transcaruncular approach was used in 19 of 24 orbits. There were no complications related to either approach.
CONCLUSIONS: Orbital bone removal and fracture reduction may be safely completed through a combined transfornix-transcaruncular approach. The transcaruncular approach provides excellent and safe exposure of the medial orbital wall, and it avoids scarring associated with the Lynch approach.
DESIGN: Retrospective, noncomparative, case series with description of surgical technique.
PARTICIPANTS: Twenty-five consecutive patients underwent orbital surgery by use of a transcaruncular approach.
INTERVENTION: Inferior and medial wall fracture repair or orbital decompression by means of a transcaruncular or combined transfornix-transcaruncular approach.
MAIN OUTCOME MEASURES: The surgical indications and complications were recorded for each patient.
RESULTS: Ten patients (10 orbits) underwent combined inferior and medial orbital wall fracture repair through a combined transfornix-transcaruncular approach. In 8 of 10 (80%) orbits, the inferior oblique muscle was disinserted during surgery. Fifteen patients (24 orbits) underwent orbital decompression surgery for dysthyroid orbitopathy. An isolated transcaruncular approach was used in 5 of 24 orbits, and a combined transfornix-transcaruncular approach was used in 19 of 24 orbits. There were no complications related to either approach.
CONCLUSIONS: Orbital bone removal and fracture reduction may be safely completed through a combined transfornix-transcaruncular approach. The transcaruncular approach provides excellent and safe exposure of the medial orbital wall, and it avoids scarring associated with the Lynch approach.
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