Abstract Purpose of Review To review relevant medial orbital anatomy as well as the most commonly used approaches to this space. Recent Findings The use of the endoscopic endonasal approach for access to the medial orbit, including the intraconal space, has expanded allowing for removal of previously “inoperable” pathology. Summary Each approach has their strength when considering access to the medial orbit, the transcaruncular incision allows for fast access with limited dissection while the transpalebral approach allows for visualization of the medial orbit but also extended access to the superior and lateral orbit. Conversely, the conjunctival approach allows for wider access to the orbital floor and the endonasal approach can be used when the pathology is medial to the optic nerve in the anterior fossa, parasellar region, and orbit.
Garvey et al. (Wed,) studied this question.