THE POSTERIOR INFERIOR ORBITOTOMY

Four patients with orbital apex tumors between the optic nerve and inf erior rectus underwent a posterior inferior orbitotomy through the max illary sinus. Three tumors were removed successfully and the fourth wa s not located, but the visual function improved after surgery, presuma bly owing to decompression of the posterior orbital floor. The techniq ue was carried out through a standard Caldwell-Luc approach through th e maxillary sinus. The posterior inferior orbital wall was removed and the inferior rectus was retracted either laterally or medially to gai n access to the tumor, which was removed microsurgically. The authors believe this approach provides a reasonably safe alternative to remove small, well-circumscribed, inferior posterior orbital apical tumors. It also avoids dissection through the orbit from other directions with the inherent risks of damaging overlying vital structures.