Obitotomía lateral mediante abordaje temporal

Abstract

Abstract: The lateral orbitotomy it still the surgical technique of choice for biopsies or the removal of intraorbital lesions that are lateral to the optic nerve, for biopsies of the optic nerve itself and for removing the lacrimal gland. Many skin incisions have been described for carrying out this surgical procedure, the most common at this moment being the upper eyelid crease incision. Although the results obtained with this incision tend to be acceptable, they are not exempt of complications, either aesthetic or functional. Over the last years new incisions have appeared that try to avoid these complications. Among the new approach routes to the lateral wall of the orbit is the temporal incision. Over the last three years four patients have undergone surgical procedures in order to carry out biopsies or for the removal of intraorbital masses by means of an incision into the temple. In all cases the incision permitted ample exposure of the surgical field and performing the procedure with ease. Excellent aesthetic and functional results were obtained with no sequelae or permanent complications. The most common complication that is specific to this incision is paresthesia of the frontal branch of the facial nerve. A careful dissection technique tends to be sufficient for avoiding this. In our view this incision, as we describe it, is the incision of choice for carrying out a lateral orbitotomy and we conclude that in our view it is aperfectly valid technique and one that should be considered with regard to the «classical» incisions, as in many aspects it surpasses these.