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ORIGINAL ARTICLE
Year : 2018  |  Volume : 17  |  Issue : 1  |  Page : 19-21

Assessment of the factors reducing operative and postoperative lateral orbitotomy complications


1 Department of Neurosurgery, Baghdad Medical College, Specialist Neuro and Orbital Surgery, Medical City, Baghdad, Iraq
2 Department of Radiology, Radiologist Specialist, Alshahid Ghazi Alhariri Hospital, Medical City, Baghdad, Iraq

Correspondence Address:
Dr. Hayder Alhemiary
Department of Neurosurgery, Baghdad Medical College, Specialist Neuro and Orbital Surgery, Medical City, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/MJ.MJ_3_18

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Background: Lateral orbitotomy is a well-known approach for lesions of the lateral, superior, and inferior part of the orbit, especially for extraconal lesions. A surgical technique which includes avoiding temporalis muscle aggressive retraction and cutting but meticulous retraction is used instead accompanied with experience of the surgeon about the anatomy of the orbit and avoiding extensive bleeding with the subsequent high infection predisposition; all these factors contribute to the low percentage of complications. Materials and Methods: Ten cases were operated upon during the period from 2012 to 2016 in medical city, neurosurgical department. In this regard, contrast-enhanced computed tomography scans gives useful information for operative strategy. All patients were approached using lateral orbitotomy procedure utilizing microsurgical technique taking in consideration meticulous retraction of the temporalis muscle, the site of the lesion, and its relation to the important orbital structure. Objective: The objective of this study is to assess of factors that minimize operative and postoperative lateral orbitotomy complications. Results: Ten cases operated with consideration to factors reducing complications of those six patients were female, with age range between 35 and 57 (mean 43 years). In four patients, the lesion was cavernous hemangioma, one patient optic nerve glioma, two patients lacrimal gland pleomorphic adenoma, and three patients exophthalmus due to Grave's disease (thyroid eye disease). With meticulous care during muscle retraction without cutting, it had no significant risk of bleeding intra operatively, one patient had early postoperative infection, and another case had unacceptable scar. Conclusion: The success of surgery can be improved, operative and postoperative complications can be reduced, and cosmetic problems become acceptable if a meticulous care is taken during temporalis muscle retraction and using microsurgical technique. Operation done by an expert surgeon familial with the anatomy of the orbit, avoiding extensive bleeding that need drainage system which predispose to high infection rate, will reduce operative and postoperative complications. In addition good operative field matching with the size and the type of the lesion play a role in minimizing the complications.


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