Conventional orbitotomy techniques and craniotomy are frequently used to access lesions in the orbital apex. The more recently described endoscopic technique with intraoperative image guidance can provide access to a subset orbital apical and periorbital skull base lesions. In carefully selected cases, this technique provides excellent visualization and access to the orbital apex and avoids larger craniofacial surgeries.

Race, gender, and age differences exist for certain eyelid and eyebrow positions. These factors can impact surgical decision-making and thus highlight the need for an individualized approach to patients.