Name of the Procedure:

Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy

Summary

An orbitotomy without bone flap is a surgical procedure used to access the eye socket (orbit) through either an incision above the eye (frontal approach) or through the eyelid (transconjunctival approach) without removing any bone. This procedure allows for the exploration and potential biopsy of tissues within the orbit.

Purpose

The orbitotomy aims to investigate abnormalities within the eye socket, such as tumors or infections, and obtain tissue samples (biopsy) if necessary. The goal is to diagnose the cause of symptoms affecting the eye or orbit and provide appropriate treatment based on those findings.

Indications

• Presence of orbital tumors or lesions
• Unexplained eye pain or swelling
• Visual disturbances linked to orbital abnormalities
• Suspicion of orbital infections or inflammatory conditions

Preparation

• Patients may be instructed to fast for a certain period before the procedure.
• Certain medications may need to be adjusted or stopped.
• Preoperative imaging (e.g., CT or MRI scans) will be conducted to guide the surgical approach.
• Blood tests and other assessments may be required to ensure the patient's fitness for surgery.

Procedure Description

1. The patient is placed under either general or local anesthesia.
2. A small incision is made either above the eye or through the eyelid, depending on the chosen approach.
3. The surgeon carefully navigates to the orbital contents without removing any bone.
4. The area is explored, and if necessary, a biopsy is taken.
5. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Orbitotomies are generally performed in a hospital operating room or a specialized surgical center.

Personnel

• Ophthalmic or oculoplastic surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses and assistants

Risks and Complications

• Infection
• Bleeding
• Scar formation
• Damage to surrounding structures, potentially affecting vision
• Anesthesia-related risks
• Swelling or bruising

Benefits

• Provides a clear diagnosis of orbital conditions.
• Allows for targeted treatment based on biopsy results.
• Minimally invasive compared to procedures requiring bone removal.

Recovery

• Patients may be monitored for a few hours or overnight.
• Mild discomfort or swelling around the incision site may occur.
• Pain medication and antibiotics may be prescribed.
• Follow-up appointments will be necessary to monitor healing.
• Recovery time varies but generally spans a few weeks.

Alternatives

• Observation and imaging (e.g., MRI, CT scans) without surgical intervention.
• Needle biopsy if less invasive diagnostic methods are sufficient.
• Endoscopic procedures for certain conditions.

Patient Experience

• During the procedure, patients will be under anesthesia and should not feel pain.
• Post-procedure, patients may experience mild pain, managed with medication.
• Swelling and bruising are common around the incision site but usually subside within a week or two.
• Most patients can resume normal activities within a few days to weeks, depending on the extent of the procedure and their overall health.