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The posterior inferior orbitotomy

J S Kennerdell¹, J C Maroon, S E Celin

¹Department of Ophthalmology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA.

Ophthalmic Plastic and Reconstructive Surgery

|August 13, 1998

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A novel surgical approach through the maxillary sinus successfully removed three of four orbital apex tumors. This posterior inferior orbitotomy technique offers a safe alternative for accessing tumors near the optic nerve.

Area of Science:

Ophthalmology
Neurosurgery
Otorhinolaryngology

Background:

Orbital apex tumors pose surgical challenges due to proximity to vital structures.
Traditional approaches may involve significant orbital dissection and risks.

Observation:

Four patients with tumors between the optic nerve and inferior rectus muscle were treated.
A posterior inferior orbitotomy was performed via a Caldwell-Luc approach through the maxillary sinus.

Findings:

Three of the four orbital apex tumors were successfully removed.
The fourth tumor was not located, but visual function improved post-surgery, likely due to orbital decompression.
The technique involved removing the posterior inferior orbital wall and retracting the inferior rectus muscle for microsurgical tumor removal.

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Implications:

This transantral approach is a viable and potentially safer alternative for specific inferior posterior orbital apex tumors.
It minimizes dissection within the orbit, reducing the risk of damage to critical orbital structures.
The technique may be particularly beneficial for small, well-circumscribed tumors in this region.