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Transmaxillary approach to the orbit: an anatomic study
Engin Gönül1, Ersin Erdogan, Bulent Düz
1Department of Neurosurgery, Gulhane Medical School, Gulhane Military Medical Academy, Ankara, Turkey. egonul@gata.edu.tr
Neurosurgery
|October 2, 2003
Summary
A novel transmaxillary approach offers orbital access without craniotomy. This extradural technique provides cosmetic benefits and avoids brain retraction for inferomedial and inferolateral orbital lesions.
Area of Science:
- Neurosurgery
- Ophthalmology
- Anatomy
Background:
- Traditional cranial, lateral, and medial approaches to the orbit often require craniotomy.
- Craniotomy necessitates brain retraction, posing potential risks and complications.
Purpose of the Study:
- To develop and evaluate a transmaxillary approach for orbital exposure.
- To provide an alternative surgical technique that avoids craniotomy and brain retraction.
Main Methods:
- The transmaxillary approach was developed using data from 24 orbit dissections in 12 cadaveric heads.
- A sublabial incision was made to expose the maxilla, followed by maxillotomy.
- The infraorbital nerve's course was identified, the orbital floor was opened, and the orbit was accessed.
Main Results:
- The transmaxillary approach successfully provided access to the inferomedial and inferolateral orbit.
- This technique allowed visualization of the inferior aspect of the optic nerve.
Conclusions:
- The transmaxillary approach is an entirely extradural method for orbital surgery.
- It offers cosmetic advantages and avoids the need for craniotomy and brain retraction.
- This technique is recommended for inferomedial posterior intraconal and inferolateral orbital lesions.