Transconjunctival and Transcaruncular Approaches to the Orbit

Natalie Wolkow; Suzanne K. Freitag

doi:10.1055/s-0040-1713849

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2020; 81(04): 422-434
DOI: 10.1055/s-0040-1713849

Surgical Approaches to the Orbit

Review Article

Transconjunctival and Transcaruncular Approaches to the Orbit

Natalie Wolkow

¹Department of Ophthalmology, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States

,

Suzanne K. Freitag

¹Department of Ophthalmology, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States

› Author Affiliations

Abstract

Transcaruncular and transconjunctival approaches are commonly used by ophthalmic plastic surgeons to access various orbital compartments. These approaches are versatile and may be combined with transnasal or transcranial approaches to the orbit to gain optimal access to challenging locations. A major advantage of the transcaruncular and transconjunctival approaches is the lack of a visible skin incision with excellent postoperative cosmesis. As with all orbital surgery, an in-depth knowledge of orbital anatomy and physiology, as well as meticulous hemostasis, is needed to prevent complications including globe injury, permanent vision loss, diplopia, and retrobulbar hemorrhage. This article reviews the surgical steps of these approaches. The indications for each approach and case examples are illustrated.

Keywords

orbit - transcaruncular - transconjunctival - medial wall - orbital floor - extraconal - intraconal - retrobulbar hemorrhage - caruncle - bulbar conjunctiva

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References

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