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Abstract

A number of pathologies is encountered in inaccessible areas of head and neck region such as lesions in the cranial base, orbital or deep nasal cavities and also in deep spaces of the neck. The diagnosis of such deep lesions has been revolutionary due to the advance in technologies in the field of radiology. The surgical treatment of these lesions poses a significant challenge to the operating surgeon due to anatomic complexity, difficulty in access, and surrounding vital structures. A team approach is often necessary for complete removal of the pathologies without damaging the vital structures. Access osteotomies are routinely performed for improved access to such lesions. In this, osteotomy of the maxillofacial skeleton is carried out, and repositioning of the bony skeleton is done after removal of the associated lesion. Lateral orbital osteotomies are used for improved access to deep orbital tumors. After original description of this technique by Kronlein, various modifications have been introduced by different surgeons. We present a new technique of lateral orbital osteotomy in which a pedicle is maintained for improved blood supply and faster healing of the osteotomized segment. This osteotomy technique provided satisfactory exposure of the lesion and was fixed with miniplates resulting in esthetic reconstruction of the facial morphology and function. This method enabled us to decrease the morbidity and hastens healing without compromising on the advantage of good access.

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