Endoscopic endo- and extra-orbital corridors for spheno-orbital region: anatomic study with illustrative case

摘要: Management of selected spheno-orbital meningiomas via the endoscopic transorbital route has been reported. Surgical maneuverability in a narrow corridor as that offered by orbit may be challenging. We investigate additional use an extra-orbital (EXO) path to used combination with endo-orbital (EO) corridor. Three human cadaveric heads (six orbits) were dissected at Laboratory Neuroanatomy University Barcelona. The superior eyelid approach was adopted, introducing surgical instruments both corridors. freedom analysis run determine directionality each and calculate related three anatomic targets: orbital fissure (SOF), foramen rotundum (FR), ovale (FO). also reported 37-year-old woman meningioma hyperostosis lateral wall right orbit, treated such combined approach. Combining corridors permitted greater for all targets compared alone (EO + EXO SOF: 3603.8 mm2 ± 2452.5 mm2; EO FR: 1533.0 mm2 ± 892.2 mm2; FO: 1193.9 mm2 ± 782.6 mm2). Analyzing pathway, our results showed greatest gained most medial portion considered area, namely SOF (1180.5 mm2 ± 648.3 mm2). Regarding case, using pathways, we enough nearly achieve total resection no postoperative complications. An useful increase instruments’ maneuverability, during pure approach, reach field from lateral-to-medial trajectory. Further studies are needed better define proper indications strategy.