Rochels R, Mann W J
Universitäts-Augenklinik, Mainz, Bundesrepublik Deutschland.
Fortschr Ophthalmol. 1991;88(3):283-5.
A major precondition for microsurgical removal of an orbital tumor is adequate topographic preparation of the structures involved. Cosmetic aspects also have to be considered. In this regard, the modified surgical approach presented here is superior to the familiar techniques of lateral orbitotomy. The surgical steps are as follows: hemicoronal incision of the skin starting from the superior end of the external ear, extending into the hairy temporo-frontal region, and ending close in front of the hair line. This incision is performed through the periosteum down to the bone, so that the forehead skin flap can be exposed to give complete exposure of the temporal muscle and the entire bony borders of the orbit. Following the osteoplastic removal of the lateral orbital rim and wall, the periorbita is opened and the intraorbital tumor can be removed microsurgically all along the superior, lateral, and inferior regions of the orbit and the muscle cone even in the orbital apex. The postoperative functional and cosmetic results are good.
显微手术切除眼眶肿瘤的一个主要前提条件是对相关结构进行充分的解剖学准备。还必须考虑美容方面的因素。在这方面，本文介绍的改良手术方法优于熟悉的外侧眶切开术技术。手术步骤如下：从外耳上端开始，沿颞部额部毛发区延伸，在发际线前方附近结束，做皮肤半冠状切口。该切口穿过骨膜直至骨面，以便暴露额部皮瓣，从而完全暴露颞肌和眼眶的整个骨性边界。在对眶外侧缘和眶壁进行骨成形切除后，打开眶骨膜，即使在眶尖，也可沿眼眶的上、外侧和下部区域以及肌锥对眶内肿瘤进行显微手术切除。术后功能和美容效果良好。
