Anterior Orbitotomy for Superior Orbital Mass

This is Richard Allen at the University of Iowa. This video demonstrates an anterior orbitotomy for a superior orbital mass. A conservative blepharoplasty has been marked. A flap of skin and orbicularis muscle is removed. Pressure on the globe demonstrates the area of the mass which is palpable posterior to the orbital septum. The needle tip cautery is then used to dissect through the orbital septum. The mass is identified posterior to the orbital septum. The mass is excised with Westcott scissors. In this patient, the mass had the appearance of lymphoma which was confirmed. Complete excision is not necessary for a mass that is suspected be lymphoma. The mass will be sent for both permanent as well as flow cytometry. Additional portions of the mass are resected. Hemostasis is obtained with the unipolar cautery. The upper eyelid crease incision is then closed with interrupted 5-0 fast absorbing sutures.  The patient will use erythromycin ophthalmic ointment three times per day.  The patient will return in approximately one week for reevaluation.