Anatomy of the orbit and its surgical approach

A micro anatomical and surgical study of the orbit was conducted on cadaver specimens. First of all we reviewed the anatomy of the orbit with special emphasis on microanatomical structures. Three neurosurgical approches are then described with all structures encountered along these routes. The superior approach which provides a good access to the superior part of the orbit is the only route which can explore all parts of the optic nerve even in the optic canal. The lateral compartment of the orbit could be exposed by the lateral approach above or below the lateral rectus muscle. It is the only route that could give access to the inferior part of the orbit. The supero lateral approach is the largest route and has advantages of the two preceding routes. It gives access to the superior part of the orbit but not the optic canal and gives also a good exposition to the lateral part of the orbit but less than the lateral route in the inferior part. These approaches could be used to remove all intra orbital lesions apart from those located in the infero medial part of the orbit.