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Upper fornix approach combined with a superior lateral cantholysis: a minimally invasive approach to the superonasal intraconal space

  • Clinical Investigation
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Abstract

Purpose

To present a new minimally invasive approach to the deep superonasal orbit.

Methods

This retrospective study reviewed seven consecutive patients who underwent orbital surgery using an upper conjunctival fornix approach combined with a superior lateral cantholysis for tumors in the superonasal intraconal space. Charts were reviewed for demographic, radiological, clinical, and surgical data including surgical outcome and morbidities for each patient.

Results

Six benign tumors of the superonasal intraconal orbit were successfully exposed and removed using this approach, and one malignant tumor was biopsied for diagnosis. Histopathology revealed cavernous haemangioma (3 cases), solitary fibrous tumor (2 cases), schwannoma (1 case), and diffuse large B cell lymphoma (1 case). Visual acuity and ocular motility were unchanged or improved in all cases. There were no visible scars or other complications related to this approach.

Conclusion

The upper fornix approach combined with a superior lateral cantholysis is a novel technique that provides safe and excellent exposure of the deep superonasal orbit. In addition, it avoids the unnecessary morbidity of upper lid splitting, medial rectus muscle detachment, or bone removal.

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Acknowledgements

Steven J. Yoon, M.D., Specialty Eye Care, Glendale, CA, USA for manuscript editing.

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Authors and Affiliations

  1. Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic 43-gil, Songpa-gu, Seoul, 05505, Korea

    Ho-Seok Sa & Sunah Kang

  2. Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

    Ji Won Seo

Authors
  1. Ho-Seok Sa
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  2. Ji Won Seo
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  3. Sunah Kang
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Corresponding author

Correspondence to Ho-Seok Sa.

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Conflicts of interest

H-S. Sa, None; J. W. Seo, None; S. Kang, None.

Electronic supplementary material

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Video. 1 Surgical steps of upper fornix approach combined with a superior lateral cantholysis are described. Surgical video and clinical course of illustrative case are also included (MP4 32729 kb)

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Sa, HS., Seo, J.W. & Kang, S. Upper fornix approach combined with a superior lateral cantholysis: a minimally invasive approach to the superonasal intraconal space. Jpn J Ophthalmol 61, 361–367 (2017). https://doi.org/10.1007/s10384-017-0514-0

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  • DOI: https://doi.org/10.1007/s10384-017-0514-0

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