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Lateral Orbital Wall

paries lateralis orbitae

The lateral orbital wall is the strongest and thickest of the four orbital walls, formed anteriorly by the orbital surface of the zygomatic bone and posteriorly by the greater wing of the sphenoid. The two bones meet at the sphenozygomatic suture. Whitnall tubercle on the inner zygomatic surface provides attachment for the lateral palpebral ligament, lateral check ligament, and the lateral horn of the levator aponeurosis.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The lateral orbital wall is decompressed in thyroid eye disease (Graves orbitopathy) through a lateral orbitotomy or transconjunctival approach, removing the bone between the superior orbital fissure and the inferior orbital fissure to provide posterior orbital expansion and reduce proptosis. The wall is the preferred access route for lateral orbital tumours and orbital apex lesions. In zygomatic complex fractures, the lateral orbital wall at the sphenozygomatic suture must be anatomically reduced to restore orbital volume.

Pathology

Common Injuries & Conditions

Orbital Decompression in Thyroid Eye Disease

Bilateral lateral orbital wall removal through a transconjunctival or swinging eyelid approach decompresses the proptotic globe in Graves orbitopathy, reducing corneal exposure and compressive optic neuropathy, with 3-5 mm of proptosis reduction achievable per wall decompressed.

Sphenozygomatic Suture Disruption in ZMC Fracture

Zygomatic complex fractures disrupt the sphenozygomatic suture at the posterior lateral orbital wall, indicated by lateral orbital wall separation on CT and requiring anatomic reduction through a lateral brow or upper blepharoplasty approach to restore orbital volume.