Evaluation of osteoplastic orbitotomy

Orbital tumors, malignant or benign, have to be removed in total and intact. In addition, malignant tumors should be operated with a minimum of manipulation. Wide access to the operational field must be preferred for difficult cases. Anterior orbitotomy is usually insufficient for retrobulbar pathology. Lateral orbitotomy improves the accessibility by removing the lateral margin of the orbit. A still wider view can be obtained by removing the upper insertion of the zygomatic bone and, if necessary, by removing the superior orbital rim or even the roof as well. The choice depends upon the location of the tumor, on the size of the tumor and last but not least, on the nature of the tumor. Coronal incision of the skin facilitates the wide approach.