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Background In an effort to avoid the damage and inconvenience associated with transcranial approaches, we developed an endoscopic transmaxillary transMuller's muscle approach for decompression of the superior orbital fissure (SOF). Methods The endoscopic transmaxillary transMuller's muscle route was performed in ten cadaveric heads. We measured important anatomic landmarks, and angles radiographically. This approach was initially attempted in one patient with traumatic superior orbital fissure syndrome (tSOFS). Results A maxillary antrostomy was carried out with a buccal sulcus incision. The sinus ostium and the course of infraorbital nerve were used as endoscopic anatomic landmarks. Then the inferior orbital fissure was drilled out, followed by separating the Muller's muscle. The periorbita were peeled off from the lateral wall, followed by the endoscope going along the periorbital space, until the lateral aspect of the SOF could be visualized. Decompression was successfully performed in all specimens. The initial clinical application justified this approach. The patient had an uneventful postoperative course and satisfactory recovery. Conclusion This approach offers sufficient endoscopic visualization and reliable decompression of SOF. It avoids the need for brain retraction, temporalis muscle manipulation, or any external incision, and appears to be able to deliver satisfying aesthetic results as well as favourable functional recovery.

Introduction: To evaluate the different multi-detector computed tomography (MDCT) features between pulmonary malignant focal ground-glass opacity (fGGO) nodules and solid nodules of 3 cm or less in diameter. Methods: One hundred and five malignant solid nodules and 48 malignant fGGOs confirmed by pathology were retrospectively analysed with regard to the patient's demographic data, nodule size and MDCT features (shape, margin, interface, internal characteristics and adjacent structure). Differences were analysed using the Fisher exact test or Mann–Whitney U-test. Results: The male to female ratio of patients with malignant solid nodules (60:45) was higher than that with malignant fGGOs (18:30) (P 0.05) or nodule size (P > 0.05). The frequency of irregular shape (4% vs. 21%), spiculation (57% vs. 40%), vacuole sign (11% vs. 52%) and natural air bronchograms (0% vs. 24%) was significantly different between malignant solid nodules and fGGOs. No differences were found in the frequency of lobulation, cusp angle, spine-like process, interface and adjacent structure between the two groups (P > 0.05). Conclusion: Malignant fGGOs and solid nodules showed mostly similar MDCT features. For malignant fGGOs, the frequency of irregular shape, vacuole sign and natural air bronchograms was higher than that in solid nodules, but the frequency of spiculation was lower than that in solid nodules.

To evaluate the different multi-detector computed tomography (MDCT) features between pulmonary malignant focal ground-glass opacity (fGGO) nodules and solid nodules of 3cm or less in diameter.One hundred and five malignant solid nodules and 48 malignant fGGOs confirmed by pathology were retrospectively analysed with regard to the patient's demographic data, nodule size and MDCT features (shape, margin, interface, internal characteristics and adjacent structure). Differences were analysed using the Fisher exact test or Mann-Whitney U-test.The male to female ratio of patients with malignant solid nodules (60:45) was higher than that with malignant fGGOs (18:30) (P0.05). There was no significant difference in either patient's age (P0.05) or nodule size (P0.05). The frequency of irregular shape (4% vs. 21%), spiculation (57% vs. 40%), vacuole sign (11% vs. 52%) and natural air bronchograms (0% vs. 24%) was significantly different between malignant solid nodules and fGGOs. No differences were found in the frequency of lobulation, cusp angle, spine-like process, interface and adjacent structure between the two groups (P0.05).Malignant fGGOs and solid nodules showed mostly similar MDCT features. For malignant fGGOs, the frequency of irregular shape, vacuole sign and natural air bronchograms was higher than that in solid nodules, but the frequency of spiculation was lower than that in solid nodules.