The orbit is the eye socket which houses the eye and other parts of the optic anatomy such as the optic nerves, extra ocular muscles that help in the movement of the eye, the nerves and other associated structures that supply the blood to the eye structure.

Tumors of the orbit can appear anywhere in the orbital area and also tumors may invade the orbit while originating from surrounding areas such as brain cavity, the nasal cavity and the paranasal sinuses. The tumor may also grow on the bones and enter the confines of the orbit.

Orbital tumors can be of various types such as; dermoids, hemangiomas, neurofibromas, sarcoma, lymphangiomas, orbital meningioma and metastatic lesions.

Tumors of the orbit may affect adult and children as well. Fortunately, most orbital tumors are benign and can be treated completely. But if the tumor is not treated well in time, it may result in complete vision loss.

For the resection of orbital tumors a procedure known as orbital tumor surgery is performed, which is also known as Orbitotomy. The use of traditional techniques and procedures implies that the resection of tumors would involve the optic nerve and as a result the critical structures may get affected due to direct or vascular damage.

The surgery is complex as the anatomy of the eye is complicated as well as delicate. Therefore it should be performed only by very skilled surgeons. The orbital tumor surgery/Orbitotomy aims at:-

  • To preserve the vision and preserve the eye of the patient.
  • To prevent the tumor from spreading to other parts of the body.
  • To relieve the symptoms of the eye cancer and restore the health of the patient.

In extreme cases, where the treatment is not done in time or not done properly, an enucleation (removal of the eye) may be required. Therefore, Orbitotomy should be performed by a team of highly skilled doctors and surgeons, including a plastic surgeon, an ophthalmic surgeon as well as a neurosurgeon. In the cases, where enucleation is done, a prosthetic eye may be attached to muscles. This gives more natural looking results because the eyes moves in conjunction which the other healthy eye.

Approach during the surgery

Since the eye orbit is area is delicate, one of the common difficulties happens in deciding in what approach to take for the resection of tumor. This is a complex and delicate procedure therefore in all major hospitals the procedure is generally carried out by a team of opthalmologists and neurosurgeons together. Depending on where the tumor is located the surgeons may be able to reach it from above or below the eye in which case the incisions are made either along the eyebrow or the eyelid or they may take a lateral approach.

The duration of the surgery may be between six to eight hours which depends on the complexity of the lesion. As part of the resection procedure, reconstruction of the eye orbit and the skull may also be required. Diseases which are acquired due to trauma or tumors like Grave’s disease or Paget’s disease may also require reconstruction. For reconstruction purposes, skin grafting may be done with tissues taken from the patients’ body. Modern advancements in medicine has led to the invention of materials which can be used as substitutes like hydroxyapatite cement, porous polyethylene, resorbable fixation devices etc.

In some extreme cases of Grave’s diseases, repositioning of the eyelids may be required. In few cases, repositioning of eyes may also be needed.

As the orbital areas, have limited access, endoscopic procedures are done to ensure limited manipulation of the tissues. With endoscopes it is also ensured that the neurovascular supply is not compromised.

Recovery

The patient is hospitalized for one to two weeks depending upon the procedure. The rate of recovery differs from one patient to another.  Also, it depends upon the size of the tumor, the complications of the procedure. Generally, the swelling and the bruising subside within two weeks. It is advised to the patients to restrict their general activities and rest as much as possible. Thanks to the modern minimally invasive procedures, the scarring is minimum and the scars fade away in a period of six months to a year.

It is important to recognize the symptoms of orbital tumor to make sure the treatment is done in time. It is advised to see an ophthalmologist immediately if a person is experiencing the following symptoms:-

  • Double/ blurry vision
  • Loss of vision
  • Persistent redness in the eyes
  • Continuous tearing of the eyes
  • Abnormally large eyes or bulging eyes
  • Constantly tired eyes

If someone is experiencing the aforementioned symptoms, it is advisable to consult an ophthalmologist without delay. If diagnosed in time, the orbital tumors are completely curable. The treatment should be taken from a reputed hospital or medical centre only.

The orbit is the eye socket, which houses the eye and other parts of the ophthalmic anatomy such as the optic nerves, extra ocular muscles that help in the movement of the eye, the nerves and other associated structures that supply the blood to the eye structure.

Need of Orbitotomy Surgery

Tumors of the orbit can appear anywhere in the orbital area and also tumors may invade the orbit while originating from surrounding areas such as brain cavity, the nasal cavity and the paranasal sinuses. The tumor may also grow on the bones and enter the confines of the orbit.

Orbital tumors can be of various types such as; dermoids, hemangiomas, neurofibromas, sarcoma, lymphangiomas, orbital meningioma and metastatic lesions.

Tumors of the orbit may affect adult and children as well. Fortunately, most orbital tumors are benign and can be treated completely using Orbitotomy surgery as one of the options. But if the tumor is not treated well in time, it may result in complete vision loss.

For the resection of orbital tumors a procedure known as orbital tumor surgery is performed, which is also known as Orbitotomy surgery. The use of traditional techniques and procedures of surgery implies that the resection of tumors would involve the optic nerve and as a result the critical structures may get affected due to direct or vascular damage of the Orbitotomy.

The surgery is complex as the anatomy of the eye is complicated as well as delicate. Therefore it should be performed only by very skilled surgeons in Orbitotomy. The orbital tumor surgery/Orbitotomy aims at:-

  • To preserve the vision and preserve the eye of the patient.
  • To prevent the tumor from spreading to other parts of the body.
  • To relieve the symptoms of the eye cancer and restore the health of the patient.

In extreme cases, where the treatment is not done in time or not done properly, an enucleation (removal of the eye) may be required. Therefore, Orbitotomy should be performed by a team of highly skilled doctors and surgeons, including a plastic surgeon, an ophthalmic surgeon as well as a neurosurgeon. In the cases, where enucleation is done, a prosthetic eye may be attached to muscles. This gives more natural looking results because the eyes moves in conjunction which the other healthy eye.

Approach during the surgery

Since the eye orbit is area is delicate, one of the common difficulties happens in deciding in what approach to take for the resection of tumor during the surgery for Orbitotomy. This is a complex and delicate surgery therefore in all major hospitals the procedure is generally carried out by a team of ophthalmologists and neurosurgeons together. Depending on where the tumor is located the surgeons may be able to reach it from above or below the eye in which case the incisions are made either along the eyebrow or the eyelid or they may take a lateral approach.

The duration of the surgery may be between six to eight hours which depends on the complexity of the lesion. As part of the resection procedure of Orbitotomy, reconstruction of the eye orbit and the skull may also be required. Diseases which are acquired due to trauma or tumors like Grave’s disease or Paget’s disease may also require reconstruction. For reconstruction purposes during the surgery, skin grafting may be done with tissues taken from the patients’ body. Modern advancements in medicine has led to the invention of materials which can be used as substitutes like hydroxyapatite cement, porous polyethylene, resorbable fixation devices etc.

In some extreme cases of Grave’s diseases, repositioning of the eyelids may be required. In few cases, repositioning of eyes may also be needed as the part of Orbitotomy.

As the orbital areas, have limited access, endoscopic procedures are done to ensure limited manipulation of the tissues. With endoscopes it is also ensured that the neurovascular supply is not compromised.

Different types of Orbitotomy surgery

Orbitotomy is a surgical procedure and therefore it has to be done under the hands of the experts only. There are various types of Orbitotomy surgery which include lateral Orbitotomy, medial Orbitotomy, anterio Orbitotomy and complex Orbitotomy. Each of these surgeries treats a specific problem and the surgeon will be able to decide what kind of surgery is required to restore the normal functioning of your eyes.

Lateral Orbitotomy Surgery

Lateral Orbitotomy surgery is a successful method to remove the orbital tumors and decompression. However the disadvantage of the process is that is very time consuming and requires extensive repairs. In the Lateral Orbitotomy method the surgeon will make the cuts through the lateral orbital rim to remove and rewire the bone. Lateral Orbitotomy is used very successfully in dysthroid eye disease. It is also used in patients with globe rupture and orbital disruption.

Medial Orbitotomy Surgery

Medial Orbitotomy procedure is generally used in the treatment of Grave’s disease. Medial Orbitotomy as the name suggests is used to remove the orbital tumors that are located on the media side of the optic nerve. Medial Orbitotomy is also used to fix fractures in the medial orbit area. Medial Orbitotomy surgery is also known as the smith surgery

Anterior Orbitotomy surgery

In this kind of Orbitotomy surgery of anterio Orbitotomy best cosmetic results are achieved easily. In anterio Orbitotomy procedure no bone is removed and this is a big advantage of the procedure. Anterio Orbitotomy surgery process has been in existence since the year 1857 which makes it one of the oldest forms of Orbitotomy surgery.

Complex Orbitotomy

The orbital structure is a complex one and to have a safe surgery sometimes a combination of various techniques of Orbitotomy are used to repair the fractures and remove the tumor. Careful planning is required for complex Orbitotomy to determine the right approach. Complex Orbitotomy can be invasive and might call for large incisions and substantial amount of bone removal. The purpose of using complex Orbitotomy like the combination of lateral and medial Orbitotomy is to provide better exposure and reduce the invasive approaches thus producing better results.

Recovery after the Orbitotomy surgery

The patient is hospitalized for one to two weeks depending upon the procedure. The rate of recovery differs from one patient to another.  Also, it depends upon the size of the tumor, the complications of the procedure. Generally, the swelling and the bruising subside within two weeks. It is advised to the patients to restrict their general activities and rest as much as possible. Thanks to the modern minimally invasive procedures, the scarring is minimum and the scars fade away in a period of six months to a year.

It is important to recognize the symptoms of orbital tumor to make sure the treatment is done in time. It is advised to see an ophthalmologist immediately if a person is experiencing the following symptoms:-

  • Double/ blurry vision
  • Loss of vision
  • Persistent redness in the eyes
  • Continuous tearing of the eyes
  • Abnormally large eyes or bulging eyes
  • Constantly tired eyes

If someone is experiencing the aforementioned symptoms, it is advisable to consult an ophthalmologist without delay. If diagnosed in time, the orbital tumors are completely curable. The treatment should be taken from a reputed hospital or medical centre only.

Whatever might be the method of the surgery your surgeon might recommend to you as Orbitotomy depending on the extent of the repair needed to your orbital structure, you have to make sure that you get the best surgeon for Orbitotomy surgery. The best surgeon will give make sure that you get proper instructions for the care you need to take after the surgery. Orbitotomy is an intricate surgery and various types of the surgeries have to be carefully evaluated before proceeding.