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.
Shorr
N
N
Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, UCLA School of Medicine, Los Angeles, California, USA.
Baylis
H I
HI
Goldberg
R A
RA
Perry
J D
JD
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