Transcaruncular approach to the medial orbit and orbital apex.
OBJECTIVE
To present a versatile approach to the medial orbit and orbital apex through the caruncle.


METHODS
Retrospective, noncomparative, case series with description of surgical technique.


METHODS
Twenty-five consecutive patients underwent orbital surgery by use of a transcaruncular approach.


METHODS
Inferior and medial wall fracture repair or orbital decompression by means of a transcaruncular or combined transfornix-transcaruncular approach.


METHODS
The surgical indications and complications were recorded for each patient.


RESULTS
Ten patients (10 orbits) underwent combined inferior and medial orbital wall fracture repair through a combined transfornix-transcaruncular approach. In 8 of 10 (80%) orbits, the inferior oblique muscle was disinserted during surgery. Fifteen patients (24 orbits) underwent orbital decompression surgery for dysthyroid orbitopathy. An isolated transcaruncular approach was used in 5 of 24 orbits, and a combined transfornix-transcaruncular approach was used in 19 of 24 orbits. There were no complications related to either approach.


CONCLUSIONS
Orbital bone removal and fracture reduction may be safely completed through a combined transfornix-transcaruncular approach. The transcaruncular approach provides excellent and safe exposure of the medial orbital wall, and it avoids scarring associated with the Lynch approach.
Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, UCLA School of Medicine, Los Angeles, California, USA.
N
N
Shorr
H I
HI
Baylis
R A
RA
Goldberg
J D
JD
Perry
D019299:Decompression, Surgical; D006111:Graves Disease / Q000601:surgery; D006801:Humans; D013508:Ophthalmologic Surgical Procedures; D009915:Orbit / Q000601:surgery*; D009916:Orbital Diseases / Q000601:surgery*; D009917:Orbital Fractures / Q000601:surgery; D012189:Retrospective Studies