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Ophthalmology. 2000 Aug;107(8):1459-63.

Transcaruncular approach to the medial orbit and orbital apex.

Author information

1
Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, UCLA School of Medicine, Los Angeles, California, USA.

Abstract

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.

PMID:
10919889
[Indexed for MEDLINE]

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