Swinging door lateral orbitotomy for management of anteriorly placed orbital tumours

A 70 years old female; who came to us; with drooping of right upper eyelid, gradual progressive diminution of vision with a slowly progressive swelling over right upper outer orbit of 1 year duration. Examination revealed non-axial proptosis with downward and inward deviation of the right eye. An irregular, lobulated nontender swelling was present in the superolateral orbit. CT scan revealed a well circumscribed oval encapsulated lesion with no bony destruction. The mass was removed by a modified lateral orbitotomy without removing lateral orbital rim. Histopathological evaluation showed it to be a pleomorphic adenoma of the lacrimal gland. Patient made an uneventful postoperative recovery. This presentation describes a method of lateral orbitotomy for anterior orbital lesions in which the lateral orbital rim is swung outwards without detaching it from its attachment to the temporalis muscle. This surgical approach may reduce the chance of avascular necrosis of the lateral orbital wall bone and infections of the orbit.