[Frontobasal osteoplastic orbitotomy in surgical treatment of intraorbital processes]

A modified frontobasal osteoplastic orbitotomy with reconstruction of the orbital roof for operative approach to intraorbital processes of any localization and of different origin (tumors, foreign bodies etc.) will be presented. After a small trapezium-shaped frontal craniotomy, the superior orbital rim and the orbital roof are resected in one piece by means of an oscillating saw. This "orbital flap" has a triangular shape, its long tip pointing to the canal of the optic nerve. There is no significant retraction of the frontal lobe by using microscope. The orbital flap is replaced and fixed by two miniplates of Luhr. This technique facilitates a significantly better exposure of all intraorbital structures than other surgical approaches, reduces operative trauma, and has better postoperative functional results. In the last 4 years we have operated upon 16 cases by means of this method, which will be presented. Although in many cases the frontal sinus was involved there was only one infection. Most common postoperative complication (50%) has been lesion of the levator palpebrae muscle followed by ptosis, which usually improved after 4-6 weeks.