Lateral orbitotomy 2

This is Richard Allen at the University of Iowa. This video demonstrates a lateral orbitotomy through a lateral canthotomy incision in a patient with presumed orbital inflammation in the posterior superior lateral orbit. A lateral canthotomy and inferior and superior cantholysis are performed with the needle tip cautery. 4-0 silk suture is then placed through the lateral upper and lower lid to provide traction during the case. Dissection is then carried out laterally along the posterior surface of the orbicularis muscle to the [lateral] orbital rim. The lateral orbital rim is then incised with the monopolar cautery. The periosteum is then elevated from the lateral orbital wall with the freer periosteal elevator. This exposes the periorbita superior lateral in the area of the presumed inflammation. Meringotomy forceps and Yasergill scissors are then used to make an incision through the periorbita to expose the abnormal tissue. Specimens are then obtained for pathological examination. Hemostasis can be attained with bipolar cautery. Specimens are usually sent for both immunopathology as well as normal pathology for patients with inflammation.