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The Lateral Orbitotomy Approach for Intraorbital Lesions
Ryan P Lee1, Adham M Khalafallah1, Abhishek Gami1
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
Journal of Neurological Surgery. Part B, Skull Base
|October 19, 2020
Summary
The lateral orbitotomy approach (LOA) provides excellent access to orbital lesions lateral to the optic nerve. Modern techniques expand its utility, offering safe and effective treatment with low complication rates for various orbital pathologies.
Area of Science:
- Ophthalmology
- Neurosurgery
- Surgical Oncology
Background:
- The lateral orbitotomy approach (LOA) is a well-established surgical technique for accessing orbital pathologies.
- Pathology location is a key determinant in selecting the optimal surgical approach for orbital lesions.
Purpose of the Study:
- To review the lateral orbitotomy approach (LOA), detailing its technique, indications, limitations, and outcomes.
- To highlight the expanded applications of LOA with modern surgical advancements.
Main Methods:
- Review of literature on the lateral orbitotomy approach (LOA).
- Discussion of modern surgical techniques, including endoscopy.
- Analysis of case series data regarding indications, complications, and outcomes.
Main Results:
- LOA is ideal for intraconal and extraconal lesions lateral to the optic nerve.
- Common indications include primary, extraorbital, and metastatic orbital tumors.
- Modern techniques and endoscopy have expanded LOA's applicability to deeper orbital apex and intracranial pathologies.
- Low rates of permanent complications such as vision loss and extraocular muscle palsy are reported.
Conclusions:
- The lateral orbitotomy approach (LOA) is a versatile and safe technique for managing a wide range of orbital pathologies.
- Multidisciplinary collaboration is crucial for optimal patient outcomes.
- Advancements in surgical technique and technology continue to broaden the indications for LOA.
