Versatility of Lateral Orbitotomy Approach for Intra-orbital Lesions-A Retrospective Study

Orbital tumors can occur in any part of the orbit. The safest and the most direct approach should be chosen based on the location and the extension of the tumor. The lateral orbitotomy was first described by Kronlein in 1889.

This retrospective study evaluates the effectiveness of lateral orbitotomy in accessing pathologies within the lateral orbit. 10 patients underwent lateral orbitotomy to treat lesions lateral to the optic nerve. The patients' mean follow-up period ranged from 2 to 3 years.

Preoperatively, all patients presented with proptosis, while 80% had decreased visual acuity, 40% experienced diplopia, and 40% had restricted extraocular movements. Postoperatively, all patients showed significant improvement in proptosis, while 100% of those with diplopia and 100% of those with restricted extraocular movements experienced complete resolution of their symptoms. However, one patient developed ophthalmoplegia as a post-operative complication. Definitive surgical outcomes were graded as good, when postoperatively the visual acuity and ocular mobility were normal and the proptosis remitted partially or completely, fair, when the visual acuity remained unchanged but the proptosis reduced significantly and poor, when post-operative permanent visual impairment and irreversible proptosis were observed. Good surgical outcome was seen in eight patients, fair in one patient and poor in one patient.

Our study demonstrates that lateral orbitotomy is a safe and effective approach for accessing lesions in the lateral and superolateral compartments of the orbital cavity, offering good aesthetic outcomes and minimal morbidities compared to transcranial approaches.