ABSTRACT
This chapter aims to demystify the surgical approaches to the orbit, and to objectify safe surgical procedures to enable full dissection and exposure of the fracture configuration with minimal risk to important anatomical structures. The management of orbital trauma has evolved considerably in the last decade. Advances in diagnosis have followed considerable improvements in imaging to enable precise and detailed knowledge of orbital fracture patterns. With advances in surgical access and landmark papers in orbital bone analysis leading to preformed anatomical plates, the surgeon now has an armamentarium potentially able to replicate three-dimensional anatomy with a degree of perfection. The posterior limit of the safe dissection rests with the orbital plate of the palatine bone, a relatively strong structure which provides a constant landmark and a convenient place to seat the posterior limit of the reconstruction material. The importance of the articulation of the zygomatic bone and sphenoid is recognised as one of the key areas to check reconstruction.
