ABSTRACT
Background The aim of our study was a pictorial documentation of the anatomical structures of the orbit. Methods We performed a transmaxillary endoscopic approach in nine formalin-fixed human heads. We identified and documented the anatomy of the inferior part of the orbit. Results The first intraorbital anatomical landmark was the inferior rectus muscle, from which important structures medially and laterally could be identified. Anatomical structures and their relation to each other were documented and presented as illustrative figures. Conclusion Knowledge of the topographic anatomy of the inferior part of the orbit could be sufficiently imparted by our illustrations. The presented transmaxillary approach allowed a wide overview of the anatomical structures located in the inferior part of the orbit. Our pictorial documentation may provide neurosurgeons more safety and the opportunity to become familiar with the endoscopic anatomy.
ABSTRACT
OBJECTIVE: In this surgical-anatomical cadaveric study we investigate the feasibility of the transmaxillary endoscopic approach to the intraorbital space. Anatomical landmarks are defined, the endoscopic view in the orbital space is studied and complications that can occur are discussed. METHODS: Nine formalin-fixed heads were used to study the transmaxillary endoscopic approach to the orbit. The approach was used twice on each head (once for each maxilla). Therefore, we report our results on 18 transmaxillary intraorbital approaches. For better differentiation of anatomical structures, the veins and arteries were injected with blue and red plastic respectively in six cadaveric heads. RESULTS: The transmaxillary approach enables viewing the inferior intraconal structures without endangering the infraorbital nerve and its artery and without diversion of the inferior rectus muscle. The optic nerve was visualised more easily through the approach medial to the inferior rectus muscle instead of lateral to the muscle since the ciliary nerves are in the way in the lateral approach. The combination of the approaches medial and lateral to the inferior rectus muscle allows very good identification of all important anatomical structures in the inferior intraconal space. CONCLUSION: The transmaxillary endoscopic approach to the orbit is a useful new approach in the surgical armamentarium for orbital lesions. The overview of the inferior part of the orbit is excellent, and the lateral part of the optic nerve can be visualised. Careful anatomical dissection allows visualisation of important anatomical structures in the orbit without damaging nerves or arteries.
