1Department of Neurological Surgery, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain.
2Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II," Naples, Italy.
Neurosurg Focus. 2024 Apr;56(4):E5. doi: 10.3171/2024.1.FOCUS23846.
The endoscopic superior eyelid transorbital approach has garnered significant consideration and gained popularity in recent years. Detailed anatomical knowledge along with clinical experience has allowed refinement of the technique as well as expansion of its indications. Using bone as a consistent reference, the authors identified five main bone pillars that offer access to the different intracranial targeted areas for different pathologies of the skull base, with the aim of enhancing the understanding of the intracranial areas accessible through this corridor.
The authors present a bone-oriented review of the anatomy of the transorbital approach in which they conducted a 3D analysis using Brainlab software and performed dry skull and subsequent cadaveric dissections.
Five bone pillars of the transorbital approach were identified: the lesser sphenoid wing, the sagittal crest (medial aspect of the greater sphenoid wing), the anterior clinoid, the middle cranial fossa, and the petrous apex. The associations of these bone targets with their respective intracranial areas are reported in detail.
Identification of consistent bone references after the skin incision has been made and the working space is determined allows a comprehensive understanding of the anatomy of the approach in order to safely and effectively perform transorbital endoscopic surgery in the skull base.
经眼眶内窥镜上眼睑眶外侧入路近年来受到广泛关注并得到普及。详细的解剖学知识和临床经验使该技术得到了改进，并扩大了其适应证。作者以骨作为恒定的参照，确定了五个主要的骨柱，这些骨柱可通向颅底不同病变的不同颅内靶向区域，旨在增强对通过该通道可到达的颅内区域的理解。
作者对经眶外侧入路的解剖结构进行了基于骨的回顾性分析，他们使用 Brainlab 软件进行了 3D 分析，并进行了干颅骨和随后的尸体解剖。
确定了经眶外侧入路的五个骨柱：较小的蝶骨翼、矢状嵴（较大的蝶骨翼内侧）、前床突、中颅窝和岩骨尖。详细报告了这些骨靶点与各自颅内区域的关联。
在皮肤切口后和确定工作空间后识别出一致的骨参照，可全面了解该入路的解剖结构，以便在颅底安全有效地进行经眶内窥镜手术。
