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The Laryngoscope
Article . 2019 . Peer-reviewed
License: Wiley Online Library User Agreement
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The Laryngoscope
Article . 2020
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Endoscopic endonasal superomedial orbitectomy: How far is safe and possible?

Authors: Eugenio Cárdenas Ruiz‐Valdepeñas; Ariel Kaen; Emilio González‐Martínez; Paul A. Gardner; Eric W. Wang; Carl H. Snyderman; Juan C. Fernandez‐Miranda;

Endoscopic endonasal superomedial orbitectomy: How far is safe and possible?

Abstract

ObjectivesDuring the endoscopic endonasal approach (EEA) to the anterior cranial base, the lateral boundaries are the lamina papyracea (medial orbital walls) bilaterally but further extension in the coronal plane is possible by performing a superomedial orbitectomy. The aims of this study are to describe the technique of the endoscopic endonasal transethmoidal supraorbital approach to the anterior cranial base and to calculate the extension in the coronal plane added with the superomedial orbitectomy.MethodsThirty superomedial orbitectomies via EEA were completed in 15 fresh‐frozen heads. After finishing the procedure, a bifrontal craniotomy with removal of both frontal lobes was performed in order to measure the width of the supraorbital EEA in the coronal plane. We divided the anterior cranial base into five zones related to distinct anatomical segments: sinusal zone, post‐sinusal zone, anterior ethmoidal, inter‐ethmoidal zone, and posterior ethmoidal zone. Measurements of each segment of the anterior cranial base were taken.ResultsIn all specimens, it was possible to perform a superomedial orbitectomy without excessive retraction of the orbital contents. The inter‐ethmoidal zone is the segment where the lateral extension was widest. The mean total width in this area was 45.4 mm. The superomedial orbitectomy added a mean of 8 mm on each side to the total anterior skull base exposure.ConclusionThe endoscopic endonasal superomedial orbitectomy added important extension in the coronal plane during an EEA to the anterior cranial base. The inter‐ethmoidal zone has shown the greatest lateral extension.Level of EvidenceN/ALaryngoscope, 130:1151–1157, 2020

Keywords

Adult, Male, Skull Base, Endoscopic limits, Endoscopy, Superomedial orbitectomy, Nose, Transorbital approach, Cadaver, Feasibility Studies, Humans, Female, Anterior cranial base, Orbit, Craniotomy

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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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