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Updated: Jun 18, 2026

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Total lateral orbitotomy.

Jonathan W Kim1, Barbara S Yates, Robert A Goldberg

  • 1Division of Oculofacial and Orbital Surgery, Department of Ophthalmology, Stanford Medical Center, Palo Alto, California, USA. JKim6@stanford.edu

Orbit (Amsterdam, Netherlands)
|November 26, 2009
PubMed
Summary
This summary is machine-generated.

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Total lateral orbitotomy (TLO) safely enhances surgical access to deep orbital lesions. This technique allows orbital surgeons to reach the orbital apex predictably through an eyelid approach, improving outcomes for posterior orbital tumors.

Area of Science:

  • Ophthalmology
  • Neurosurgery
  • Anatomy

Background:

  • Surgical access to deep orbital structures, particularly the orbital apex, presents significant challenges.
  • Traditional approaches may offer limited visualization and increased risk to vital neurovascular structures.

Purpose of the Study:

  • To evaluate the safety and efficacy of total lateral orbitotomy (TLO) for improving surgical exposure of the deep orbit.
  • To assess the feasibility of TLO in cadaveric specimens and its clinical application for deep orbital lesions.

Main Methods:

  • Dissection of ten orbits from five fresh-frozen cadaver heads to analyze TLO techniques.
  • Removal of an orbital bone flap from the supraorbital to infraorbital nerve, augmented by high-speed burr removal of the sphenoid bone.
  • Clinical application in five patients with posterior orbital tumors, recording surgical outcomes and clinical results.

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Main Results:

  • TLO allows removal of the entire orbital rim without compromising neurovascular structures or dura.
  • Strategic bone removal from the deep lateral wall significantly improves access to the orbital apex.
  • Five patients with deep orbital lesions achieved excellent surgical outcomes using TLO.

Conclusions:

  • Total lateral orbitotomy provides safe and predictable access to the orbital apex via an eyelid approach.
  • This technique empowers orbital surgeons to manage deep orbital lesions more effectively.