67412 Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion

Name of the Procedure:

Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion

Summary

Orbitotomy without bone flap is a surgical procedure designed to remove a lesion from the orbit (eye socket) through either a frontal or transconjunctival (through the conjunctiva of the eye) approach. This method accesses the orbit without removing any bone.

Purpose

This procedure addresses orbital lesions, which could be tumors, cysts, or other abnormal growths. The goal is to safely remove the lesion to alleviate symptoms, prevent further complications, and potentially improve vision or eye function.

Indications

• Presence of an orbital lesion (e.g., tumor, cyst)
• Symptoms such as eye pain, bulging of the eye, double vision, or reduced eye movement
• Lesions detected via imaging studies (e.g., MRI or CT scans)

Preparation

• Patients may need to fast for several hours before the procedure.
• Medication adjustments may be necessary (e.g., blood thinners might need to be discontinued).
• Preoperative diagnostic tests such as blood work and imaging studies are typically required.

Procedure Description

1. The patient is given anesthesia (general or local with sedation).
2. A small incision is made in the chosen approach area (either the frontal or transconjunctival region).
3. Specialized surgical instruments are used to expose and remove the lesion.
4. The incision is then closed with sutures or surgical adhesive.

Duration

The procedure typically takes about 1 to 3 hours, depending on the complexity and size of the lesion.

Setting

The surgery is performed in a hospital or specialized surgical center.

Personnel

• Ophthalmic surgeon or orbital specialist
• Anesthesiologist
• Surgical nurses and operating room technicians

Risks and Complications

• Infection
• Bleeding
• Damage to surrounding tissues or structures
• Vision changes or loss
• Scarring
• Anesthesia-related complications

Benefits

• Removal of the lesion
• Alleviation of symptoms (e.g., pain relief, normalized eye appearance and function)
• Potential improvement in vision
• Prevention of further orbital or vision issues

Recovery

• Post-procedure care includes managing pain with medications, applying cold compresses, and avoiding strenuous activities.
• Patients typically have a follow-up appointment to monitor healing and ensure there are no complications.
• Full recovery may take a few weeks, but most patients can resume normal activities within a few days.

Alternatives

• Observation with periodic imaging if the lesion is benign and asymptomatic
• Minimally invasive procedures such as needle aspiration or laser treatments
• Radiation therapy or chemotherapy, if the lesion is cancerous and other treatments are required

Patient Experience

Patients might feel pressure or mild discomfort during the procedure if under local anesthesia. Postoperatively, there may be swelling, bruising, and temporary vision changes. Pain is usually managed with prescribed medications and diminishes within a few days.