The transcaruncular approach uses an incision through the caruncle, the small pink tissue at the inner corner of the eye, to reach the medial orbit and surrounding bones. It offers direct access with a hidden scar.
Uses
This route is employed for medial wall and frontoethmoidal fractures, orbital decompression, and some tumour or lesion removals. It allows surgeons to work along natural tissue planes while preserving eyelid structures.
- Often combined with trans‑conjunctival or endonasal techniques for extended exposure
- Requires meticulous closure to maintain caruncle position and appearance
- Provides good cosmetic outcomes with minimal external evidence of surgery
- Performed by oculoplastic or orbital surgeons familiar with regional anatomy
Post-Operative Care
Swelling, bruising, and inner‑corner discomfort are common initially but usually improve within weeks. Lubricants and topical medications aid surface comfort.
- Complications can include scarring, caruncle malposition, or diplopia, though these are uncommon
- Follow‑up evaluates ocular motility, cosmesis, and sinus or orbital healing
- Patients are advised to avoid nose‑blowing and heavy lifting early on
- Imaging may be repeated post‑operatively in complex fracture repairs
