Orbitotomy

Definition

A surgical procedure to obtain access and exposure to a particular area of the orbit.

Indications

It is performed for multiple reasons, including biopsy or excision of a lesion, decompressing the optic nerve or canal, draining an abscess, removing a foreign body, and removing bone or fat for decompression of the orbit or for orbital fracture repair (Cockerham et al. 2001; Levine 2003; Nerad 2001).

Contraindication

Contraindication for patients unable to medically tolerate surgery.

Techniques and Principles

An anterior orbitotomy is planned for a lesion in the anterior 2/3 of the orbit. A medial orbitotomy is useful for medial intra- and extraconal lesions, and a lateral orbitotomy is useful for lesions in the posterior orbit lateral to the optic nerve.

There are specifically defined surgical spaces in the orbit (Fig. 1)

Fig. 1

Surgical spaces of the orbit in coronal (a) and axial (b) view (Printed with permission from Nerad JA, ed. Oculoplastic Surgery. The requisites in...