Related Experiment Video
Updated: Aug 28, 2025
09:53
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
3.7K
Endoscopic Transorbital Approach to the Middle Fossa: Qualitative and Quantitative Anatomic Study
Giulia Guizzardi1, Alejandra Mosteiro2, Jhon Hoyos2
1Division of Neurosurgery, Department of Neuroscience, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy.
Operative Neurosurgery (Hagerstown, Md.)
|September 15, 2022
Summary
The endoscopic transorbital approach allows safe access to the middle cranial fossa. This study details the anatomy and limits for safe bone resection during skull base surgery.
Area of Science:
- Neurosurgery
- Anatomy
- Endoscopic Skull Base Surgery
Background:
- The endoscopic superior eyelid transorbital route is increasingly used for skull base access.
- This approach offers a novel ventral perspective for neurosurgical procedures.
Purpose of the Study:
- To evaluate middle cranial fossa anatomy via the transorbital route.
- To define safe drilling limits for middle fossa procedures using this approach.
Main Methods:
- Anatomical dissection of 5 cadaveric specimens and 2 dry skulls.
- Detailed analysis of neurovascular structures and bony landmarks.
Main Results:
- Identified critical boundaries: lateral pterygoid muscle, Gasserian ganglion, foramen rotundum, foramen spinosum, lesser sphenoid wing, and foramen ovale.
- Average bone resected: 6.49 ± 0.80 cm³ (63% of middle fossa floor).
- Surgical dimensions: axial 3.85 cm, sagittal 5.23 cm; angles: horizontal 38.14°, vertical 18.56°.
Conclusions:
- Detailed anatomy of the middle cranial fossa is presented.
- Endoscopic transorbital approach enables middle cranial fossa floor removal while respecting critical anatomical landmarks.
