Abstract
BACKGROUND: Surgical approaches to lesions in either the orbit or cavernous sinus have been well documented; however, approaching lesions involving both areas remains challenging. OBJECTIVE: To examine the microsurgical and endoscopic anatomy of the orbit and cavernous sinus as seen through the orbitozygomatic and translateral orbital wall approaches. METHODS: Seven orbits and cavernous sinuses of formalin-fixed adult cadaveric heads were dissected and examined with the aid of the surgical microscope and 0° endoscope. RESULTS: The orbitozygomatic approach exposes the superior and lateral surfaces of the orbit, optic canal, superior orbital fissure, and cavernous sinus and offers a range of visibility and enough space for manipulation in both the horizontal and vertical planes. The translateral orbital wall approach exposes the lateral surface of the orbit, optic canal, and superior orbital fissure and can be extended to the lateral wall of the cavernous sinus. However, the surgical corridor to the orbital apex and adjacent cavernous sinus is narrow and deep. Endoscopic assistance may increase the exposure, especially around the anterior clinoid process and as far back as V3. CONCLUSION: The translateral orbital wall approach with endoscopic assistance provides access to the orbit and cavernous sinus, making it a good alternative to the orbitozygomatic approach for biopsy of unresectable lesions and removal of selected small lesions limited to the lateral aspect of the orbit and cavernous sinus.
| Original language | English |
|---|---|
| Pages (from-to) | 360-373 |
| Number of pages | 14 |
| Journal | Operative Neurosurgery |
| Volume | 12 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Jan 1 2016 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Clinical Neurology
Cite this
Translateral orbital wall approach to the orbit and cavernous sinus : Anatomic study. / Matsuo, Satoshi; Komune, Noritaka; Iihara, Koji; Rhoton, Albert L.
In: Operative Neurosurgery, Vol. 12, No. 4, 01.01.2016, p. 360-373.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Translateral orbital wall approach to the orbit and cavernous sinus
T2 - Anatomic study
AU - Matsuo, Satoshi
AU - Komune, Noritaka
AU - Iihara, Koji
AU - Rhoton, Albert L.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - BACKGROUND: Surgical approaches to lesions in either the orbit or cavernous sinus have been well documented; however, approaching lesions involving both areas remains challenging. OBJECTIVE: To examine the microsurgical and endoscopic anatomy of the orbit and cavernous sinus as seen through the orbitozygomatic and translateral orbital wall approaches. METHODS: Seven orbits and cavernous sinuses of formalin-fixed adult cadaveric heads were dissected and examined with the aid of the surgical microscope and 0° endoscope. RESULTS: The orbitozygomatic approach exposes the superior and lateral surfaces of the orbit, optic canal, superior orbital fissure, and cavernous sinus and offers a range of visibility and enough space for manipulation in both the horizontal and vertical planes. The translateral orbital wall approach exposes the lateral surface of the orbit, optic canal, and superior orbital fissure and can be extended to the lateral wall of the cavernous sinus. However, the surgical corridor to the orbital apex and adjacent cavernous sinus is narrow and deep. Endoscopic assistance may increase the exposure, especially around the anterior clinoid process and as far back as V3. CONCLUSION: The translateral orbital wall approach with endoscopic assistance provides access to the orbit and cavernous sinus, making it a good alternative to the orbitozygomatic approach for biopsy of unresectable lesions and removal of selected small lesions limited to the lateral aspect of the orbit and cavernous sinus.
AB - BACKGROUND: Surgical approaches to lesions in either the orbit or cavernous sinus have been well documented; however, approaching lesions involving both areas remains challenging. OBJECTIVE: To examine the microsurgical and endoscopic anatomy of the orbit and cavernous sinus as seen through the orbitozygomatic and translateral orbital wall approaches. METHODS: Seven orbits and cavernous sinuses of formalin-fixed adult cadaveric heads were dissected and examined with the aid of the surgical microscope and 0° endoscope. RESULTS: The orbitozygomatic approach exposes the superior and lateral surfaces of the orbit, optic canal, superior orbital fissure, and cavernous sinus and offers a range of visibility and enough space for manipulation in both the horizontal and vertical planes. The translateral orbital wall approach exposes the lateral surface of the orbit, optic canal, and superior orbital fissure and can be extended to the lateral wall of the cavernous sinus. However, the surgical corridor to the orbital apex and adjacent cavernous sinus is narrow and deep. Endoscopic assistance may increase the exposure, especially around the anterior clinoid process and as far back as V3. CONCLUSION: The translateral orbital wall approach with endoscopic assistance provides access to the orbit and cavernous sinus, making it a good alternative to the orbitozygomatic approach for biopsy of unresectable lesions and removal of selected small lesions limited to the lateral aspect of the orbit and cavernous sinus.
UR - http://www.scopus.com/inward/record.url?scp=85045887961&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85045887961&partnerID=8YFLogxK
U2 - 10.1227/NEU.0000000000001145
DO - 10.1227/NEU.0000000000001145
M3 - Article
C2 - 29506281
AN - SCOPUS:85045887961
VL - 12
SP - 360
EP - 373
JO - Operative Neurosurgery
JF - Operative Neurosurgery
SN - 2332-4252
IS - 4
ER -