Cách tiếp cận phương pháp tiếp cận mở rộng mí mắt dưới cung cấp truy cập vào toàn bộ vành quỹ đạo bên một điểm vượt trội so với khâu frontozygomatic khoảng 10 đến 12 mm. Đối với điều này tiếp xúc thêm, tuy nhiên, amore vết rạch hào phóng và rộng phá hoại là cần thiết. | ALTERNATIVE TECHNIQUE EXTENDED LOWER EYELID APPROACH The extended lower eyelid approach provides access to the entire lateral orbital rim to a point approximately 10 to 12 mm superior to the frontozygomatic suture. For this added exposure however amore generous incision and wide undermining are necessary. Additionally the lateral canthal tendon must be stripped from its insertions and carefully repositioned. In spite of these concerns the approach is useful when one requires access to the entire lateral orbit lateral orbital rim orbital floor and inferior orbital rim. The incision for the extended subciliary approach is exactly as described for the standard subciliary incision but the incision must be extended laterally approximately 1 to 1 5 cm in a natural crease see Fig. 2-13 . If no natural skin crease extends laterally from the lateral palpebral fissure the extension can usually be made straight laterally or slightly inferolaterally. Supraperiosteal dissection of the entire lateral orbital rim is performed with scissor dissection to a point above the frontozygomatic suture Fig. 2-29 . The orbicularis oculi musculature and superficial portion of the lateral canthal tendon are retracted as the dissection proceeds. Figure 2-29 Technique used to obtain increased exposure of the lateral orbital rim. The initial incision is extended laterally 1 to 1 5 cm and supraperiosteal dissection along the lateral orbital rim proceeds 36 With retraction an incision through the periosteum 2 to 3 mm lateral to the lateral orbital rim is made from the highest point obtained with supraperiosteal dissection Fig. 2-30 . The periosteal incision is connected to the one described from the standard approach to the orbital floor and infraorbital rim see previous text . Subperiosteal dissection must strip all of the tissue from the orbital floor and lateral orbital wall. This includes stripping the insertions of the deep portion of the lateral canthal tendon Lockwood s suspensory ligament
