Fixation-free lateral orbitotomy using the periosteal covering technique for orbital tumor excision

To present outcomes of a lateral orbitotomy technique with periosteal coverage of the osteotomized segment instead of traditional fixation with a plate and screws. This retrospective interventional case series presents the outcomes of lateral orbitotomy with periosteal coverage of the osteotomized segment. We included all patients who underwent the lateral orbitotomy technique for intraorbital tumor removal between January 2005 and January 2021. Data on demographics, presenting signs and symptoms, clinical and histological diagnoses, and intraoperative and postoperative complications were collected and analyzed. A total of 40 patients were eligible for inclusion. The mean age was 38.8 ± 17.08 years (range: 6 months to 65 years), and the mean follow-up period was 46.73 ± 24.15 months (range: 12-91 months). In all patients, the mass was completely excised, and the lateral orbital wall was successfully replaced using the "periosteal covering technique" without the need for K-wires or mini-plates for fixation. Postoperatively, there were no cases of non-union or malunion. Rare skin scars and occasional pain or tenderness at the surgical site were noted, along with a non-visible but palpable small bony step-off at the orbital rim edge. The periosteal covering technique appears to be a safe, simple, and time-efficient method for replacing osteotomized segments in cases of lateral orbitotomy with osteotomy during orbital tumor excision.