The Inferolateral Transorbital Endoscopic Approach: A Preclinical Anatomic Study

Area of Science:

• Neurosurgery
• Anatomy

Background:

• Transorbital endoscopic approaches are gaining popularity for accessing the lateral ventral skull base.
• These methods provide multiple corridors through the orbit.

Purpose of the Study:

• To investigate the feasibility of the inferolateral transorbital endoscopic approach (ILTEA).
• To detail the step-by-step dissection, identify anatomic landmarks, and define target areas for ILTEA.

Main Methods:

• Dissection of seven cadaveric specimens (14 sides) in an endoscopic anatomy laboratory.
• Detailed step-by-step ILTEA dissection to identify landmarks and corridors.
• Use of neuronavigation to verify landmarks and measure orbital dislocation (<10 mm).

Main Results:

• Defined one key anatomic area, the "waterline door," providing access to four distinct surgical corridors.
• Identified and analyzed crucial anatomic landmarks relevant to the approach.
• Confirmed minimal orbital dislocation (<10 mm) with the ILTEA.

Conclusions:

• ILTEA offers a direct surgical pathway to the "waterline door," lateral ventral skull base, and middle cranial fossa.
• The approach provides optimal visualization of the intracranial and extracranial segments of the maxillary and mandibular nerves.
• Further studies are recommended to validate ILTEA in clinical surgical practice.