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The Eyelid Trans-orbital Trans-cavernous Approach to the Basilar Apex: A Cadaveric Proof-of-Concept Study
Xiaochun Zhao1, Jeremy Tan2, Mohamed A Labib3
1Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States.
Journal of Neurological Surgery. Part B, Skull Base
|May 12, 2025
Summary
This study demonstrates combining the eyelid transorbital approach with the pretemporal transcavernous technique. This minimally invasive method provides deep exposure to the basilar apex and cavernous sinus.
Area of Science:
- Neurosurgery
- Surgical Anatomy
Background:
- The pretemporal transcavernous approach offers exposure to the basilar apex.
- This approach is traditionally performed with a frontotemporal incision.
- A minimally invasive eyelid transorbital approach has unique attributes.
Purpose of the Study:
- To demonstrate the combination of the eyelid transorbital and pretemporal transcavernous approaches.
- To provide a proof-of-concept for this combined surgical technique.
Main Methods:
- Cadaveric dissection of a latex-injected head.
- Step-by-step demonstration of the combined approach.
- Focus on pretemporal osteotomy, anterior clinoidectomy, and transcavernous dissection.
Main Results:
- The eyelid transorbital approach facilitates pretemporal osteotomy and anterior clinoidectomy.
- This combined approach provides access to the basilar apex and its branches.
- The trajectory is narrower, offering a complementary inferior corridor perspective.
Conclusions:
- Combining the eyelid transorbital and pretemporal transcavernous approaches allows deep exposure via a minimally invasive incision.
- This technique may offer an additional surgical option for the cavernous sinus and basilar apex regions.
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