Lateral approach to the orbit: an anatomical study.

The authors have identified and described three lateral approaches to the intraorbital portion of the optic nerve in cadavers. The structures exposed via the superior, inferior or central approaches were directed through the lateral orbital wall. The superior approach in which the lateral rectus muscle is retracted inferiorly exposes the superolateral aspect of the orbit. The inferior approach in which the lateral rectus muscle is retracted superiorly, provided the inferolateral aspect of the optic nerve from the globe to the muscle cone. The central approach in which the lateral rectus muscle was disinserted and retracted provided excellent exposure of the structures of the lateral part of the orbit and the optic nerve. There were no structures blocking access to the ciliary ganglion and two third anterior optic nerve and lateral surface of the globe. The structures encountered in these approaches are demonstrated under magnification in cadavers, and the exposure of the optic nerve is discussed.