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Updated: May 25, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Lateral orbital wall approach to the cavernous sinus.

Tamer Altay¹, Bhupendra C K Patel, William T Couldwell

¹Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA.

Journal of Neurosurgery

|January 17, 2012

Summary

A novel translateral orbital wall approach offers a direct path to the cavernous sinus, simplifying surgical access for related lesions. This extradural technique avoids brain retraction and temporalis muscle disruption.

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Area of Science:

Neurosurgery
Surgical Anatomy

Background:

Cavernous sinus lesions present significant surgical challenges.
Standard frontotemporal craniotomy is the typical approach, often requiring brain retraction.

Observation:

The translateral orbital wall approach involves lateral canthal incision and removal of orbital walls.
The anterior clinoid process is removed for cavernous sinus exposure.
Further sphenoid wing removal enhances access to surrounding structures.

Findings:

This approach provides complete exposure of the cavernous sinus.
It allows access to the lateral middle fossa and petrous carotid artery.
An illustrative case of cavernous sinus meningioma is presented.

Implications:

The translateral orbital wall approach is a simple and rapid method for cavernous sinus lesions.
Advantages include extradural access, no brain retraction, and preserved temporalis muscle.
This technique offers a valuable alternative for managing complex cavernous sinus pathologies.