The lateral triangle flap--a new approach for lateral orbitotomy

Lateral orbitotomy with or without removal of the lateral wall enables access to the extraconal and intraconal spaces of the orbit lateral to the optic nerve. We present the lateral triangle flap technique using an upper eyelid skin crease incision and skin incision from the lateral canthal angle joining together laterally at the outer margin of the lateral orbital rim, just beyond the lateral orbital margin. A triangular skin muscle flap is raised medially, based at the canthal angle, providing maximal exposure of the lateral and superolateral orbital wall. The deep lateral orbital wall can be burred away for lateral orbital decompression, or a bone flap removed for exposure of deep intraconal or extraconal lesions. The lateral triangle flap provides excellent exposure and postoperative cosmetic results.