LeFort I orbitotomy: a new approach to the inferonasal orbital apex

Numerous approaches to the orbit have been elegantly described in the literature. One area of the orbit that remains difficult to approach with standard techniques is the inferonasal apex. We describe a new surgical procedure we have termed the LeFort I orbitotomy. The technique involves creation of a LeFort I osteotomy to separate the maxilla from the zygoma and nose bilaterally. The posterior inferomedial orbital bone is then removed and the periorbita opened. This approach allows a more direct, less tangential view to this area of the orbit than does a Caldwell-Luc approach. Wider access for tumor manipulation is gained than would be possible with a transnasal endoscopic approach. An illustrative case report is presented.