Endoscopic transorbital approach to anterolateral skull base through inferior orbital fissure: a cadaveric study

Lin, Benjamin C.; Ju, Da‐Tong; Hsu, Tzu-Hsien; Chung, Tzu-Tsao; Liu, Wei-Hsiu; Hueng, Dueng‐Yuan; Chen, Yuan-Hao; Hsia, Chung-Ching; Ma, Hsin‐I; Liu, Mingying; Hung, Hung-Chang; Tang, Chi‐Tun

doi:10.1007/s00701-019-03993-3

Cited by 17 publications

(19 citation statements)

References 33 publications

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“…The PS approach is useful to access to the inferior orbit [38,47]. It can be combined with LRC or PC to increase maneuverability and exposure of the lateral and medial orbital quadrants, respectively (Fig.…”

Section: Preseptal Approachmentioning

confidence: 99%

“…When the defect is extended beyond the limits of the orbit (e.g., frontal sinus, cribriform plate, planum sphenoidale, lateral recess of the sphenoid), watertight closure should be achieved following the principles of transnasal endoscopic SB reconstruction [3,41,47,48,58]. Various materials such as autologous grafts (e.g., fascia lata, temporalis fascia, iliotibial tract, abdominal fat, septal mucoperichondrium) or synthetic materials (e.g., TachoSil®, AlloDerm®, DuraGen®) have been used either alone or in combination [8,12,14,16,28,29,31,32,34,38,40,41,43,48,53,58]. In the majority of the studies, a multilayer reconstruction was conducted.…”

Section: Reconstructionmentioning

confidence: 99%

“…In addition, in order to prevent postoperative enophthalmos, Medpor can be placed over the dural defect as a buttress [29]. When the lateral orbital rim was removed in extended TOA, the orbital rim can be reconstructed by a mini plate or a titanium mesh [29,38].…”

Section: Reconstructionmentioning

confidence: 99%

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Transorbital endoscopic approaches to the skull base: a systematic literature review and anatomical description

et al. 2021

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Transorbital endoscopic approaches are increasing in popularity as they provide corridors to reach various areas of the ventral skull base through the orbit. They can be used either alone or in combination with different approaches when dealing with the pathologies of the skull base. The objective of the current study is to evaluate the surgical anatomy of transorbital endoscopic approaches by cadaver dissections as well as providing objective clinical data on their actual employment and morbidity through a systematic review of the current literature. Four cadaveric specimens were dissected, and step-by-step dissection of each endoscopic transorbital approach was performed to identify the main anatomic landmarks and corridors. A systematic review with pooled analysis of the current literature from January 2000 to April 2020 was performed and the related studies were analyzed. Main anatomical landmarks are presented based on the anatomical study and systematic review of the literature. With emphasis on the specific transorbital approach used, indications, surgical technique, and complications are reviewed through the systematic review of 42 studies (19 in vivo and 23 anatomical dissections) including 193 patients. In conclusion, transorbital endoscopic approaches are promising and appear as feasible techniques for the surgical treatment of skull base lesions. Surgical anatomy of transorbital endoscopic approaches can be mastered through knowledge of a number of anatomical landmarks. Based on data available in the literature, transorbital endoscopic approaches represent an important complementary that should be included in the armamentarium of a skull base team.

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Section: Preseptal Approachmentioning

confidence: 99%

Section: Reconstructionmentioning

confidence: 99%

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Transorbital endoscopic approaches to the skull base: a systematic literature review and anatomical description

et al. 2021

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“…The inferior orbital fissure (IOF) affords a narrow space between the posterior two‐thirds of the lateral orbital wall and the floor of the orbit. It may serve as a gateway to deep anatomical spaces of the face, including the infratemporal fossa (ITF) and pterygopalatine fossa (PPF) 1,2 . Lesions in these two regions are notoriously challenging to resect due to a propensity for significant vascularity resulting in blood loss and obscuration of the surgical field, and their proximity to critical neurovascular structures.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic transorbital ligation of the maxillary artery through the inferior orbital fissure

et al. 2021

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Objective Determine the feasibility of accessing the internal maxillary artery (IMA) through a transorbital endoscopic assisted approach through the inferior orbital fissure (IOF). Materials and Methods Six adult cadaveric specimens were injected intravascularly with colored latex and dissected on 12 sides. A transorbital endoscopic approach was used to expose the IOF and reach the IMA. Results The average length and width of the anterolateral segment of the IOF were 7.3 and 4 mm, respectively, on the right side and 6.7 and 3.8 mm, respectively, on the left side. Surgical exposure and modification of the IOF allowed the exposure and control of the IMA in all 12 sides. Conclusions The IOF is a feasible portal to the IMA. The benefits of this approach include vascular control of the distal segment of the maxillary artery. It may provide access in clinical scenarios where endonasal access is not possible (e.g., extensive tumors) or serve as an alternative or complementary surgical route (e.g., control during a total or radical maxillectomy).

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“…[7][8][9][10][11][12][13] In a cadaveric study, Lin et al described that the endoscopic transorbital approach through inferior orbital fissure was feasible to access the anterolateral skull base without sacrificing any critical neurovascular structure. 13 Being newly developed approach to the anterolateral skull base, the superiority of endoscopic transorbital route is unknown. Until now, there is no study to make quantitative comparison between endoscopic transorbital approach and other endoscopic transmaxillary approaches.…”

Section: Introductionmentioning

confidence: 99%

Quantitative comparison of endoscopically assisted endonasal, sublabial and transorbital transmaxillary approaches to the anterolateral skull base

Lin

Hsu

et al. 2020

Clinical Otolaryngology

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Objectives: The aim of this anatomical study is to make quantitative comparison among three endoscopic approaches, encompassing contralateral endonasal transseptal transmaxillary transpterygoid approach (contralateral EEA), endoscopic sublabial transmaxillary transalisphenoid (Caldwell-Luc) approach and endoscopic transorbital transmaxillary approach through inferior orbital fissure (ETOA), to the anterolateral skull base for assisting preoperative planning. Design & Participants: Anatomical dissections were performed in four adult cadaveric heads bilaterally using three endoscopic transmaxillary approaches described above.

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Endoscopic transorbital approach to anterolateral skull base through inferior orbital fissure: a cadaveric study

Cited by 17 publications

References 33 publications

Transorbital endoscopic approaches to the skull base: a systematic literature review and anatomical description

Transorbital endoscopic approaches to the skull base: a systematic literature review and anatomical description

Endoscopic transorbital ligation of the maxillary artery through the inferior orbital fissure

Quantitative comparison of endoscopically assisted endonasal, sublabial and transorbital transmaxillary approaches to the anterolateral skull base

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