2020–2021 BCSC Basic and Clinical Science Course™
7 Oculofacial Plastic and Orbital Surgery
Part I: Orbit
Chapter 7: Orbital Surgery
Surgical Spaces
There are 5 surgical spaces within the orbit (Fig 7-1):
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the subperiosteal surgical space, which is the potential space between the bone and the periorbita (periosteum of the orbit)
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the extraconal surgical space, which lies between the periorbita and the muscle cone
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the sub-Tenon surgical space, which lies between the Tenon capsule and the globe
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the subarachnoid surgical space, which lies between the optic nerve and the nerve sheath
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the intraconal surgical space, which lies within the muscle cone
A single orbital lesion may involve more than 1 surgical space, and a combination of approaches may be necessary for pathologic processes affecting the orbit. An operating microscope is sometimes used, particularly for dissection inside the muscle cone. The approaches to these spaces—superior, inferior, medial, and lateral—are discussed in the following sections. Incisions used to reach these surgical spaces are shown in Figure 7-2.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.