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Surgical Approaches to the Orbit and Optic Nerve

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Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery

Abstract

In 1888, Kronlein introduced the concept of lateral orbital rim removal to access deep orbital lesions. While this approach is still employed to this day, today’s aesthetically oriented orbital surgeon has a myriad of new minimally invasive techniques in their armamentarium. Orbital imaging continues to improve with more sensitive and higher resolution computed tomography (CT) and magnetic resonance imaging (MRI) scanning technologies. Multidisciplinary collaborations have facilitated newer surgical approaches through the sinuses and transcranial routes. Technological advancements in the instrumentation of today’s orbital surgeon have also improved in the 15 years since the last edition of this chapter. Finally, advances in anesthesia techniques have allowed more cases to be performed in an outpatient setting with less sedation.

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Suggested Reading

  1. Arya AK et al. Late periorbital haemorrhage following functional endoscopic sinus surgery: a caution for potential day case surgery. BMC Ear Nose Throat Disord. 2006;6:11.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Ben Simon G et al. Rethinking orbital imaging: establishing guidelines for interpreting orbital imaging studies and evaluating their predictive value in patients with orbital tumors. Ophthalmology. 2005;112(12):2196–207.

    Article  PubMed  Google Scholar 

  3. Berke RN. A modified Kronlein operation. Trans Am Ophthalmol Soc. 1953;51:193.

    CAS  PubMed Central  PubMed  Google Scholar 

  4. Calcaterra TC. Diagnosis and management of ethmoid cerebrospinal rhinorrhea. Otolaryngol Clin North Am. 1985;18:99–105.

    CAS  PubMed  Google Scholar 

  5. Cannon PS et al. The surgical management and outcomes for spheno-orbital meningiomas: a 7-year review of multi-disciplinary practice. Orbit. 2009;28(6):371–6.

    Article  PubMed  Google Scholar 

  6. Collin R, Rose G. Plastic and orbital surgery. London: BMJ Books; 2001.

    Google Scholar 

  7. Hongobo Y et al. Navigation-guided reduction and orbital floor reconstruction in the treatment of zygomatic-orbital-maxillary complex fractures. J oral Maxillofac surg. 2010;68(1):28–34.

    Article  Google Scholar 

  8. Jones BR. Surgical approaches to the orbit. Trans Ophthalmol Soc UK. 1970;90:269.

    CAS  PubMed  Google Scholar 

  9. Kasperbauer JL, Hinkley L. Endoscopic orbital decompression for Graves’ ophthalmopathy. Am J Rhinol. 2005;19:603–6.

    PubMed  Google Scholar 

  10. Kennerdell JS, Dekker A, Johnson BL. Orbital fine needle aspiration biopsy: the results of its use in 50 patients. Neuroophthalomol. 1980;1:117.

    Article  Google Scholar 

  11. Kennerdell JS et al. Fine needle aspiration biopsy: its use in orbital tumors. Arch Ophthalmol. 1979;97:1315.

    Article  CAS  PubMed  Google Scholar 

  12. Kennerdell JS et al. CT-guided fine needle aspiration biopsy of orbital optic nerve tumors. Ophthalmology. 1980;87:491.

    Article  CAS  PubMed  Google Scholar 

  13. Krohel GB. Blepharoptosis following traumatic third nerve palsies. Am J Ophthalmol. 1979;88:598.

    CAS  PubMed  Google Scholar 

  14. Long JC, Ellis PP. Total unilateral visual loss following orbital surgery. Am J Ophthalmol. 1971;71:218.

    CAS  PubMed  Google Scholar 

  15. Norris JL, Cleasby GW. Endoscopic orbital surgery. Am J Ophthalmol. 1981;91:249–52.

    CAS  PubMed  Google Scholar 

  16. Norris JL, Stewart WB. Bimanual endoscopic orbital biopsy: an emerging technique. Ophthalmology. 1985;92:34–8.

    Article  CAS  PubMed  Google Scholar 

  17. Pelton RW, Patel BCK. Superomedial lid crease approach to the medial intraconal space. Ophthal Plast Reconstr Surg. 2001;17:241–53.

    Article  CAS  PubMed  Google Scholar 

  18. Pham AM, Strong EB. Endoscopic management of facial fractures. Curr Opin Otolaryngol Head Neck Surg. 2006;14:234–41.

    Article  PubMed  Google Scholar 

  19. Prabhakaran VC et al. Orbital endoscopic surgery. Indian J Ophthalmol. 2008;56(1):5–8.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Rosen N, Priel A, Ben Simon GJ, Rosner M. Cryo-assisted anterior approach for surgery of retroocular orbital tumours avoids the need for lateral or transcranial orbitotomy in most cases. Acta Ophthalmol. 2010;88:675–80.

    Article  PubMed  Google Scholar 

  21. Reese AB. Tumors of the eye. 3rd ed. New York: Harper & Row; 1976.

    Google Scholar 

  22. Reese AB. Expanding lesions of the orbit. Trans Ophthalmol Soc UK. 1971;91:85.

    CAS  PubMed  Google Scholar 

  23. Rootman J, Stewart B, Goldberg RA. Orbital surgery – a conceptual approach. Philadelphia: Lippincott Raven; 1995.

    Google Scholar 

  24. Schyberg E. Fine needle biopsy of orbital tumors. Acta Ophthalmol Suppl. 1975;125:11.

    PubMed  Google Scholar 

  25. Smith GB. Anesthesia for orbital surgery: observed changes in the visually evoked response at low blood pressures. Mod Probl Ophthalmol. 1975;14:457.

    CAS  PubMed  Google Scholar 

  26. Smith JL. Anterolateral approach to the orbit. Trans Am Acad Ophthalmol Otolaryngol. 1971;75:1059.

    CAS  PubMed  Google Scholar 

  27. Spoor TC et al. Orbital fine needle aspiration biopsy with B-scan guidance. Am J Ophthalmol. 1980;89:274.

    CAS  PubMed  Google Scholar 

  28. Stallard HB. Surgery of the orbit. Ann R Coll Surg Engl. 1968;43:125.

    CAS  PubMed Central  PubMed  Google Scholar 

  29. Tanna N et al. Surgical treatment of subperiosteal orbital abscess. Arch Otolaryngol. 2008;134(7):764–7.

    Article  Google Scholar 

  30. Tao J, Nunery W, Kresovsky S, Lister L, Mote T. Efficacy of fentanyl or alfentanil in suppressing reflex sneezing after propofol sedation and periocular injection. Ophthal Plast Reconstr Surg. 2008;24:465–7.

    Article  PubMed  Google Scholar 

  31. Vairavan N et al. Minimally invasive image-guided removal of retrobulbar intraconal foreign body. Orbit. 2009;28(6):442–3.

    Article  CAS  PubMed  Google Scholar 

  32. Westman-Naeser S, Naeser P. Tumors of the orbit diagnosed by fine needle biopsy. Acta Ophthalmol. 1978;56:969.

    Article  CAS  Google Scholar 

  33. Verity DH et al. Natural history of periocular capillary haemangiomas: changes in internal blood velocity and lesion volume. Eye. 2006;20(10):1228–37.

    Article  CAS  PubMed  Google Scholar 

  34. Write JE. The role of surgery in the management of orbital tumors. Mod Probl Ophthalmol. 1975;14:553.

    Google Scholar 

  35. Write JE, Stewart WB, Krohl GB. Clinical presentation and management of lacrimal gland tumors. Br J Ophthalmol. 1979;63:600.

    Article  Google Scholar 

  36. Xian J et al. Value of MR imaging in the differentiation of benign and malignant orbital tumors in adults. Eur Radiol. 2010;20(7):1692–702.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Oculofacial Plastic and Reconstructive Surgery, UCSD Department of Ophthalmology, Shiley Eye Center, La Jolla, CA, USA

    Ayelet Priel M.D., Sang-Rog Oh M.D., Don O. Kikkawa M.D. & Bobby S. Korn M.D., Ph.D., F.A.C.S.

Authors
  1. Ayelet Priel M.D.
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  2. Sang-Rog Oh M.D.
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  3. Don O. Kikkawa M.D.
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  4. Bobby S. Korn M.D., Ph.D., F.A.C.S.
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Corresponding author

Correspondence to Bobby S. Korn M.D., Ph.D., F.A.C.S. .

Editor information

Editors and Affiliations

  1. Department of Ophthalmology, Associate Professor of Ophthalmology Wayne State University School of Med, Detroit, Michigan, USA

    Evan H. Black

  2. Oakland University William Beaumont, Clinical Professor of Ophthalmology Director, Oculoplastic Surgery, Southfield, Michigan, USA

    Frank A. Nesi

  3. Department of Ophthalmology, University of Central Florida, Orlando, USA

    Christopher J. Calvano

  4. William Beaumont School of Medicine, Clinical Professor of Ophthalmology Co-Director, Oculoplastic Surgery, Detroit, Michigan, USA

    Geoffrey J. Gladstone

  5. Former Chief of Ophthalmology, Emeritus Clinical Prof of Ophthalmology Case Western Reserve University, South Euclid, USA

    Mark R. Levine

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Priel, A., Oh, SR., Kikkawa, D.O., Korn, B.S. (2012). Surgical Approaches to the Orbit and Optic Nerve. In: Black, E., Nesi, F., Calvano, C., Gladstone, G., Levine, M. (eds) Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0971-7_55

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  • DOI: https://doi.org/10.1007/978-1-4614-0971-7_55

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-0970-0

  • Online ISBN: 978-1-4614-0971-7

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