A MODIFIED KRONLEIN OPERATION

TLDR

An ingenious operation for resection of the lateral wall of the orbit to remove orbital dermoids was described by Krönlein in 1888, but it has fallen into disuse because it is technically difficult, can leave an unsightly scar, offers limited working space, and has been replaced by other procedures. The authors present a simplified Krönlein operation that is easier to perform, provides greater exposure, leaves an inconspicuous scar, and avoids damage to orbital or periorbital structures. The simplified technique achieves these goals by modifying the original approach to reduce technical complexity and improve cosmetic and safety outcomes.

Abstract

AN INGENIOUS operation for resection of the lateral wall of the orbit for the removal of orbital dermoids was described by Krönlein in 1888.¹For many years this was the method of choice for the treatment of retrobulbar tumors, but of late years it has fallen into disuse in many places for several reasons: (1) The procedure as done with the Gigli saw was technically not easy; (2) an unsightly scar sometimes resulted (Fig. 1); (3) adequate working space often was lacking (Fig. 2), and (4) other procedures * completely replaced the Krönlein operation in some places. The purpose of this article is to present a simplified Krönlein operation which is relatively easy, will give greater exposure, will leave an inconspicuous scar, and, of itself, can do no damage to the orbital or periorbital structures. <h3>ANATOMY OF LATERAL WALL OF THE ORBIT</h3> Fortunately, the lateral wall is so constructed that