Superior orbital rim grinding as a novel surgical technique to approach superior and posterior orbital tumors.

PURPOSE: To describe a novel surgical technique aimed to approach those orbital lesions located superior and posterior to the equator of the globe. METHODS: We describe a novel surgical technique that was performed in four patients to approach intraorbital tumors superiorly and posteriorly located. This technique was completed through an upper eyelid skin crease followed by grinding the superior orbital rim to achieve complete removal of the lesions. RESULTS: Complete removal of the lesion was accomplished in every case. No intraoperative complications were observed in any of the patients. During the follow-up period, one patient presented with frontal hypersensitivity and one with diplopia. CONCLUSIONS: In the case series presented, the upper eyelid skin crease approach with grinding of the superior orbital rim proved to be a safe and effective surgical technique to remove lesions located superior and posterior within the orbit in our series. More studies are needed to further evaluate the efficacy and long-term results of this approach.

Transconjunctival Approach Using Lateral Skin Extension for Reconstruction of Orbit Zygomatic Complex Fractures: Technique Description and a Case Series Analysis.

STUDY DESIGN: A descriptive-observational study of a series case report of patients diagnosed with orbito-zygomatic complex (OZMC) fracture with lateral wall involvement, was conducted. All patients were assessed in the Oral and Maxillofacial Surgery Service at Hospital El Carmen, Maipu, Santiago, Chile. OBJECTIVE: The purpose of this study was to evaluate a single-institution experience with the transconjunctival approach to the orbit, utilizing a lateral skin extension as unique approach to access to fronto-zygomatic suture, infraorbital rim and/or orbital floor. METHOD: The authors identified 41 patients with OZMC fractures who underwent to surgical treatment over a 45 months period. Among this group, 21 patients needed fixation with osteosynthesis of the frontozygomatic suture, and 16 of whom were treated with the approach being studied. The authors assessed scleral exposure, eyelid position changes, ectropion, and entropion as outcome measures, and reported satisfactory outcomes at a minimum of 9 months follow-up. CONCLUSIONS: This study concludes that in our experience, the transconjunctival approach utilizing a lateral skin extension allows a direct, easy, and quick access to the entire infra orbital rim, orbital floor, fronto-zygomatic suture and lateral wall of the orbit, up to spheno-zygomatic suture, with low associated morbidity and complications.