Endoscopic Transnasal Approach for Deep Lateral Orbital Decompression: A Cadaver Study
Teppei Takeda1,2, Yasine Mirmozaffari2, Asha Nadabar2
1Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.
Objectives:
This study evaluates the anatomical feasibility of an endoscopic transnasal approach for deep lateral orbital decompression using cadaver models.
Design:
Cadaver study.
Participants:
Four fresh frozen cadaver heads (eight sides) were used.
Main Outcome Measures:
Measurements of the sphenoid trigone before and after bone removal were assessed using CT scans. Key outcome measures included the width, height, depth, and volume of the trigone.
Results:
The transnasal approach achieved a 53.9% reduction in trigone volume, with significant decreases in height (65.0%), width (84.3%), and depth (76.8%). Preoperative measurements revealed an average orbital surface width of 20.0 mm, later reduced to 16.7 mm postoperatively. The average trigone depth was reduced from 16.1 to 12.0 mm, and height decreased from 21.3 to 13.4 mm in the postoperative assessment. The procedure showed a mild limitation in reduction along the cephalocaudal axis, with residual regions measuring 4.5 and 3.0 mm in the superior and inferior directions, respectively.
Conclusion:
The endoscopic transnasal approach effectively reduces the size of the sphenoid trigone, providing a promising alternative for orbital decompression with potential clinical applications. Future research should explore long-term outcomes and integration into surgical practice.
