{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:29:14Z","timestamp":1792420154710,"version":"4.5.0"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Transcaruncular and transconjunctival approaches are commonly used by ophthalmic plastic surgeons to access various orbital compartments. These approaches are versatile and may be combined with transnasal or transcranial approaches to the orbit to gain optimal access to challenging locations. A major advantage of the transcaruncular and transconjunctival approaches is the lack of a visible skin incision with excellent postoperative cosmesis. As with all orbital surgery, an in-depth knowledge of orbital anatomy and physiology, as well as meticulous hemostasis, is needed to prevent complications including globe injury, permanent vision loss, diplopia, and retrobulbar hemorrhage. This article reviews the surgical steps of these approaches. The indications for each approach and case examples are illustrated.<\/jats:p>","DOI":"10.1055\/s-0040-1713849","type":"journal-article","created":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T18:51:13Z","timestamp":1599677473000},"page":"422-434","source":"Crossref","is-referenced-by-count":13,"title":["Transconjunctival and Transcaruncular Approaches to the Orbit"],"prefix":"10.1055","volume":"81","author":[{"given":"Natalie","family":"Wolkow","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne K.","family":"Freitag","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,9,9]]},"reference":[{"key":"ref1","volume-title":"Ophthalmic Plastic Surgery: Tricks of the Trade","author":"S K Freitag","year":"2020"},{"key":"ref2","volume-title":"Atlas of Clinical and Surgical Orbital Anatomy. 2nd dd","author":"J J Dutton","year":"2011"},{"key":"ref3","volume-title":"Oculoplastic Surgery. 3rd ed","author":"B Leatherbarrow","year":"2019"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1002\/alr.21645","article-title":"Endoscopic endonasal orbital cavernous hemangioma resection: global experience in techniques and outcomes","volume":"6","author":"B S Bleier","year":"2016","journal-title":"Int Forum Allergy Rhinol"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"e104","DOI":"10.1097\/IOP.0b013e3182a22ed1","article-title":"Endoscopic bimanual approach to an intraconal cavernous hemangioma of the orbital apex with vascularized flap reconstruction","volume":"30","author":"D Y Healy Jr.","year":"2014","journal-title":"Ophthal Plast Reconstr Surg"},{"issue":"08","key":"ref6","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/S0161-6420(00)00241-4","article-title":"Transcaruncular approach to the medial orbit and orbital apex","volume":"107","author":"N Shorr","year":"2000","journal-title":"Ophthalmology"},{"key":"ref7","volume-title":"Clinical Anatomy of the Eye. 2nd ed","author":"R S Snell","year":"1998"},{"key":"ref8","volume-title":"Histology of the Human Eye: An Atlas and Textbook","author":"M J Hogan","year":"1971"},{"issue":"07","key":"ref9","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/j.ophtha.2018.01.030","article-title":"Incidence, risk factors, and management of blindness after orbital surgery","volume":"125","author":"S M Jacobs","year":"2018","journal-title":"Ophthalmology"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1016\/0002-9394(71)90592-7","article-title":"Orbital blow-out fracture repair, conjunctival approach","volume":"71","author":"R R Tenzel","year":"1971","journal-title":"Am J Ophthalmol"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/IOP.0000000000000659","article-title":"The revised direct transconjunctival approach to the orbital floor","volume":"33","author":"F P Bernardini","year":"2017","journal-title":"Ophthal Plast Reconstr Surg"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1076\/stra.11.1.63.14089","article-title":"Anatomical observations on some parts of the eye and eyelids. 1805","volume":"11","author":"J R Tenon","year":"2003","journal-title":"Strabismus"},{"key":"ref13","volume-title":"Ophthalmology: A Pocket Textbook Atlas. 2nd Ed. PP 68","author":"G Lang","year":"2007"}],"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1713849.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T06:03:58Z","timestamp":1602828238000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1713849"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8]]},"references-count":13,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2020,10,15]]},"published-print":{"date-parts":[[2020,8]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1713849","relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"value":"2193-6331","type":"print"},{"value":"2193-634X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8]]}}}