A plea for postero-lateral orbitotomy for microsurgical removal of tumours of the orbital apex.

Lateral orbitotomy including the lateral rim of the orbit allows adequate surgical exposure for most intraorbital tumours. However, by dealing with intraconal lesions located deep at the orbital apex, the control of the posterior aspect of the growth is often less than optimal. The postero-lateral route, with bone removal mainly confined to the greater sphenoidal wing, allows a more direct approach to the posterior portion of these lesions along a plane tangential to the lateral aspect of the temporal pole. A modified surgical technique is reported, which in three consecutive cases allowed radical removal of pure apical tumours without added neurological deficits.