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The transmaxillary endoscopic approach to the orbit
Saskia Schultheiß1, Athanasios K Petridis, Rashad El Habony
1Department of Neurosurgery, Klinikum Duisburg, Wedau Kliniken, Zu den Rehwiesen 9-11, 47055, Duisburg, Germany. saskia.schultheiss@lycos.com
Acta Neurochirurgica
|November 7, 2012
Summary
The transmaxillary endoscopic approach provides an excellent view of the inferior orbit and optic nerve, offering a safe new surgical option for orbital lesions. This method allows detailed visualization of orbital structures without damaging critical nerves or arteries.
Area of Science:
- Ophthalmology
- Neurosurgery
- Anatomy
Background:
- Orbital lesions require precise surgical access.
- Endoscopic techniques offer minimally invasive options.
- The transmaxillary approach is a novel method for accessing the intraorbital space.
Purpose of the Study:
- To evaluate the feasibility of the transmaxillary endoscopic approach to the intraorbital space.
- To define anatomical landmarks relevant to this approach.
- To assess the endoscopic view and potential complications.
Main Methods:
- A surgical-anatomical cadaveric study using nine formalin-fixed heads.
- 18 transmaxillary intraorbital approaches were performed.
- Vascular injection with colored plastic was used for enhanced visualization in six heads.
Main Results:
- The transmaxillary approach allows visualization of inferior intraconal structures without damaging the infraorbital nerve or inferior rectus muscle.
- The optic nerve is more easily visualized medially to the inferior rectus muscle.
- Combining medial and lateral approaches provides comprehensive visualization of the inferior intraconal space.
Conclusions:
- The transmaxillary endoscopic approach is a valuable new technique for managing orbital lesions.
- It offers an excellent overview of the inferior orbit and lateral optic nerve.
- Careful dissection ensures visualization of orbital structures while preserving nerves and arteries.