Medial microsurgical approach to the orbit: an anatomic study

Area of Science:

• Neurosurgery
• Ophthalmology
• Anatomy

Background:

• The intraorbital optic nerve is crucial for vision.
• Surgical access to this region can be challenging.
• Understanding precise anatomical approaches is vital for neurosurgeons and ophthalmologists.

Purpose of the Study:

• To identify and describe novel medial surgical approaches to the intraorbital optic nerve.
• To evaluate the exposure provided by each approach in cadaveric specimens.
• To detail the anatomical structures encountered during these medial orbital dissections.

Main Methods:

• Three distinct medial surgical approaches (superior, inferior, central) were performed on cadaveric orbits.
• The medial orbital wall was utilized for access.
• Structures were exposed and analyzed under magnification, with particular attention to the optic nerve and surrounding tissues.

Main Results:

• The superior approach, retracting the medial rectus muscle inferiorly, exposed the superomedial orbit.
• The inferior approach, retracting the medial rectus muscle superiorly, provided inferomedial optic nerve access.
• The central approach, involving ethmoidectomy and medial rectus muscle manipulation, offered excellent exposure of the medial orbit and optic nerve, with unobstructed access to the anterior two-thirds of the nerve.

Conclusions:

• Medial surgical approaches provide viable access routes to the intraorbital optic nerve.
• The central approach offers superior exposure compared to superior and inferior methods.
• These cadaveric findings are crucial for planning optic nerve surgeries and understanding orbital anatomy.