Soliman Luke, Rhee Ben, Lerner Julia L, Sobti Nikhil, Rao Vinay, Woo Albert S
From the Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.
Plast Reconstr Surg Glob Open. 2023 May 22;11(5):e5014. doi: 10.1097/GOX.0000000000005014. eCollection 2023 May.
The transconjunctival incision is a common and effective approach for establishing surgical exposure to the orbital floor. When access to the lateral orbit is also required, this incision may be extended by an accompanying lateral canthotomy, which releases the tarsal plates from the conjunctiva. Although this approach broadens surgical access through a simple extension, it is often remarked for unpredictable healing patterns and negative aesthetic sequelae, such as rounding of the lateral canthal angle. Traditionally, lateral canthotomy is performed by a transverse incision through a natural skin crease of the lateral palpebral fissure. Herein, we discuss our experience with a less common approach to lateral canthotomy, in which only the inferior crus of the lateral canthal tendon is divided. This approach limits manipulation of delicate orbital anatomy and aims to minimize unsightly scarring while still affording excellent visualization of the lateral orbit and orbital floor.
经结膜切口是建立眶底手术暴露的常用且有效的方法。当还需要进入眶外侧时，该切口可通过联合外眦切开术进行延长，外眦切开术可使睑板与结膜分离。尽管这种方法通过简单的延长拓宽了手术入路，但它常因愈合模式不可预测和负面美学后遗症（如外眦角变圆）而受到关注。传统上，外眦切开术是通过睑外侧裂的自然皮肤皱褶处的横向切口进行的。在此，我们讨论我们采用的一种不太常见的外眦切开术方法的经验，即仅切断外眦肌腱的下脚。这种方法限制了对精细眶部解剖结构的操作，旨在尽量减少难看的瘢痕形成，同时仍能提供眶外侧和眶底的良好视野。
