Abstract
The orbit is a natural bony cavity communicating with extracranial and intracranial spaces through three openings: the superior orbital fissure (SOF), which connects the orbit with the middle cranial fossa; the inferior orbital fissure (IOF), which connects the orbit with the pterygopalatine, infratemporal, and temporal fossae; and the optic canal (OC), which connects the orbit with the supratentorial intradural space (Fig. 3.1) [1]. A detailed knowledge of the microsurgical anatomy of these bony openings, their contents, and the anatomical relationships of the encased structures is necessary for safe surgery, whether to or through the orbit.
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References
Rhoton AL. The orbit. Neurosurgery. 2002;51(4 Suppl):S303–34.
Ammirati M, Bernardo A. Anatomical study of the superior orbital fissure as seen during a pterional approach. J Neurosurg. 2007;106(1):151–6. https://doi.org/10.3171/jns.2007.106.1.151.
Fukuda H, Evins AI, Burrell JC, Iwasaki K, Stieg PE, Bernardo A. The meningo-orbital band: microsurgical anatomy and surgical detachment of the membranous structures through a frontotemporal craniotomy with removal of the anterior clinoid process. J Neurol Surg B Skull Base. 2014;75(2):125–32. https://doi.org/10.1055/s-0033-1359302.
Froelich SC, Aziz KM, Levine NB, Theodosopoulos PV, van Loveren HR, Keller JT. Refinement of the extradural anterior clinoidectomy: surgical anatomy of the orbitotemporal periosteal fold. Neurosurgery. 2007;61(5 Suppl 2):179–85. https://doi.org/10.1227/01.neu.0000303215.76477.cd; discussion 85–6.
Coscarella E, Başkaya MK, Morcos JJ. An alternative extradural exposure to the anterior clinoid process: the superior orbital fissure as a surgical corridor. Neurosurgery. 2003;53(1):162–6; discussion 6–7. https://doi.org/10.1227/01.neu.0000068866.22176.07.
Saenz A, Villalonga JF, Solari D, Baldoncini M, Mantese B, Lopez-Elizalde R, et al. Meningo-orbital band detachment: a key step for the extradural exposure of the cavernous sinus and anterior clinoid process. J Clin Neurosci. 2020;81:367–77. https://doi.org/10.1016/j.jocn.2020.09.055.
Bernardo A, Evins AI, Mattogno PP, Quiroga M, Zacharia BE. The orbit as seen through different surgical windows: extensive anatomosurgical study. World Neurosurg. 2017;106:1030–46. https://doi.org/10.1016/j.wneu.2017.06.158.
Shimizu S, Tanriover N, Rhoton AL, Yoshioka N, Fujii K. MacCarty keyhole and inferior orbital fissure in orbitozygomatic craniotomy. Neurosurgery. 2005;57(1 Suppl):152–9; discussion 9. https://doi.org/10.1227/01.neu.0000163600.31460.d8.
Aziz KM, Froelich SC, Cohen PL, Sanan A, Keller JT, van Loveren HR. The one-piece orbitozygomatic approach: the MacCarty burr hole and the inferior orbital fissure as keys to technique and application. Acta Neurochir. 2002;144(1):15–24. https://doi.org/10.1007/s701-002-8270-1.
Bernardo A, Evins AI. Anterolateral routes to the skull base-the frontotemporal approaches and exposure of the sellar and parasellar regions. World Neurosurg. 2023;172:131–45. https://doi.org/10.1016/j.wneu.2022.11.055.
De Battista JC, Zimmer LA, Theodosopoulos PV, Froelich SC, Keller JT. Anatomy of the inferior orbital fissure: implications for endoscopic cranial base surgery. J Neurol Surg B Skull Base. 2012;73(2):132–8. https://doi.org/10.1055/s-0032-1301398.
Chen HI, Bohman LE, Emery L, et al. Lateral transorbital endoscopic access to the hippocampus, amygdala, and entorhinal cortex: initial clinical experience. ORL. 2015;77(6):321–32. https://doi.org/10.1159/000438762.
Locatelli D, Restelli F, Alfiero T, et al. The role of the transorbital superior eyelid approach in the management of selected spheno-orbital meningiomas: in-depth analysis of indications, technique, and outcomes from the study of a cohort of 35 patients. J Neurol Surg B Skull Base. 2022;83(2):145–58. https://doi.org/10.1055/s-0040-1718914.
Di Somma A, Andaluz N, Cavallo LM, de Notaris M, Dallan I, Solari D, Zimmer LA, Keller JT, Zuccarello M, Prats-Galino A, Cappabianca P. Endoscopic transorbital superior eyelid approach: anatomical study from a neurosurgical perspective. J Neurosurg. 2018;129(5):1203–16. https://doi.org/10.3171/2017.4.JNS162749. PMID: 29243982.
DelGaudio JM. Endoscopic transnasal approach to the pterygopalatine fossa. Arch Otolaryngol Head Neck Surg. 2003;129(4):441. https://doi.org/10.1001/archotol.129.4.441.
Zhang X, Tabani H, El-Sayed I, Russell M, Feng X, Benet A. The endoscopic endonasal transmaxillary approach to meckel’s cave through the inferior orbital fissure. Oper Surg. 2017;13(3):367–73. https://doi.org/10.1093/ons/opx009.
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Bernardo, A., Evins, A.I., Corvino, S. (2023). Microsurgical Anatomy of the Superior and Inferior Orbital Fissures. In: Bonavolontà, G., Maiuri, F., Mariniello, G. (eds) Cranio-Orbital Mass Lesions. Springer, Cham. https://doi.org/10.1007/978-3-031-35771-8_3
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