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Review
. 2014 Sep;7(3):169-74.
doi: 10.1055/s-0034-1374063. Epub 2014 May 22.

Transconjunctival inferior orbitotomy: indications, surgical technique, and complications

Brett W Davies  1 , Eric M Hink  1 , Vikram D Durairaj  2
Affiliations
Review

Transconjunctival inferior orbitotomy: indications, surgical technique, and complications

Brett W Davies et al. Craniomaxillofac Trauma Reconstr. 2014 Sep.

Abstract

Surgical access to the inferior orbit can be accomplished through either a transcutaneous or transconjunctival incision. The preferred approach should provide adequate surgical exposure with the fewest adverse effects. The purpose of this article is to review the literature on the transconjunctival incision and to discuss the indications and complications of the approach. The authors also discuss their preferred technique and provide a step-by-step instruction. The transconjunctival approach provides good surgical access with a low incidence of complications and a better aesthetic outcome than transcutaneous approaches.

Keywords: eyelid; orbit; surgical approach; transconjunctival.

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Figures

Figure 1
Figure 1
Inferior intraorbital cyst is easily accessed and removed through a transconjunctival approach.
Figure 2
Figure 2
The transconjunctival incision is placed 1 to 3 mm inferior to the tarsal border.
Figure 3
Figure 3
The dissection is carried through the insertion of the lower lid retractors, and then inferiorly towards the orbital rim.
Figure 4
Figure 4
Electrocautery needle is used to make an incision through the periosteum at the orbital rim.
Figure 5
Figure 5
Inferior cantholysis. Note the upward vector of pull with the non-dominant hand.
Figure 6
Figure 6
Transconjunctival incision can be combined with transcaruncular and lateral canthotomy incisions for wide exposure.
Figure 7
Figure 7
Blunt dissection with tenotomy scissors carried down to the posterior lacrimal crest in a plane between the orbital septum and Horner's muscle.
Figure 8
Figure 8
Left lower lid retraction after transconjunctival lower lid blepharoplasty.
See this image and copyright information in PMC

References

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