Gönül Engin, Erdogan Ersin, Düz Bulent, Timurkaynak Erdener
Department of Neurosurgery, Gulhane Medical School, Gulhane Military Medical Academy, Ankara, Turkey.
Neurosurgery. 2003 Oct;53(4):935-41; discussion 941-2. doi: 10.1227/01.neu.0000084164.22028.10.
Various approaches to expose the orbit have been used, such as cranial, lateral, and medial approaches. In an effort to gain exposure to the orbit without necessitating a craniotomy, we have developed a transmaxillary approach to the orbit.
An approach was developed that uses data obtained by performing 24 orbit dissections in 12 cadaveric heads. After sublabial incision to expose the maxilla, maxillotomy is performed and the course of the infraorbital nerve is identified. The orbital floor is opened, and the orbit is accessed.
This technique offers access to the inferomedial and inferolateral orbit and to the inferior aspect of the optic nerve.
The transmaxillary approach provides an entirely extradural approach to the orbit. This technique combines the benefits of a cosmetically acceptable approach with orbitotomy and avoids the use of craniotomy and brain retraction to access the deep medial, lateral, and inferior orbit. We advocate the transmaxillary approach to the orbit in cases of inferomedial posterior intraconal and inferolateral lesions as an alternative and adjunct to the standard techniques of orbital surgery.
已采用多种暴露眼眶的方法，如经颅、外侧和内侧入路。为了在无需开颅的情况下暴露眼眶，我们开发了一种经上颌骨入路至眼眶的方法。
开发了一种利用在12个尸体头部进行24次眼眶解剖所获得数据的入路方法。经唇下切口暴露上颌骨后，进行上颌骨切开术并确定眶下神经的走行。打开眶底，进入眼眶。
该技术可进入眼眶的内下和外下区域以及视神经的下方。
经上颌骨入路为眼眶提供了一种完全硬膜外的入路。该技术将美观上可接受的入路与眼眶切开术的优点相结合，避免了使用开颅术和脑牵拉来进入眼眶深部的内侧、外侧和下部。对于眼眶内下锥后和外下病变，我们提倡采用经上颌骨入路至眼眶，作为眼眶手术标准技术的替代方法和辅助方法。
