Transconjunctival approach to a large cavernoma of the orbit

Orbital tumors, particularly those within the retrobulbar space, are sometimes approached by neurosurgeons as well as by ophthalmic and by maxillofacial surgeons. There are numerous descriptions for the operative techniques applied in this area. Most lesions are attacked extracranially via a lateral orbitotomy or transcranially, with or without resection of the sphenoid bone or the orbital rim. Less traumatic approaches in patients harboring a tumor in this functionally and cosmetically important region, therefore, are desirable. We describe a microneurosurgical transconjunctival approach to a large retrobulbar cavernoma in a 59-year-old man. This technique has led to a very satisfactory result, and the operation can be performed without transient section of extraocular muscles in sections.