1. Endonasal identification of the orbital apex
- Author
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Carl H. Snyderman, Miguel Soares Tepedino, Richard Louis Voegels, Carlos D. Pinheiro-Neto, Thiago Freire Pinto Bezerra, and Paul A. Gardner
- Subjects
Optic canal ,business.industry ,Anatomy ,eye diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Paranasal sinuses ,Otorhinolaryngology ,Cadaver ,Superior orbital fissure ,Ophthalmic artery ,medicine.artery ,otorhinolaryngologic diseases ,030221 ophthalmology & optometry ,medicine ,business ,Surgical endoscopy ,030217 neurology & neurosurgery ,Orbit (anatomy) ,Pterygopalatine fossa - Abstract
Objectives/Hypothesis To describe anatomical landmarks for endoscopic endonasal approaches to the orbital apex and to measure the distances between those landmarks. Methods In this anatomic study, the nasal fossae of 30 adult fresh cadavers were dissected (n = 60 half-skulls). One double-injected orbit was carefully dissected, mainly focusing on the neurovascular structures. The orbital apex was dissected under endoscopic endonasal visualization in all cases. The distances between the ethmoidal crest and choanal arch to the optic canal (OC) and superior orbital fissure (SOF) were measured and recorded. Results The sample was predominantly male (63.3%, 19/30 cadavers). The following correlations between measurements according to side were observed: ethmoidal crest to OC, r = 0.748 (P = 0.0001); ethmoidal crest to SOF, r = 0.785 (P = 0.0001); choanal arch to OC, r = 0.835 (P = 0.0001); choanal arch to SOF, r = 0.820 (P = 0.0001). Conclusions In the cadavers studied in this sample, the ethmoidal crest and choanal arch were relevant structures and exhibited consistent measurements. Spearman correlation coefficients were greater than 0.7, which is indicative of good correlation between measurements obtained in the skull halves of each cadaver. Comparison of the measurements obtained in different sides showed similar values, with no statistically significant differences in the distances between any of the proposed anatomic landmarks. Level of Evidence N/A. Laryngoscope, 2015
- Published
- 2015