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Surgical Anatomy of the Orbit

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Brain Anatomy and Neurosurgical Approaches

Abstract

The orbits are formidable structures, closely related to the base of the skull, whose contents include tissues with different origins and functions. It can be affected by numerous tumors, benign or malignant, and non-tumor processes, such as primary inflammation or inflammation secondary to systemic diseases. Traumatic events are also included. Concerning surgical interventions, defining the most appropriate approach involves a precise preoperative radiological definition of the lesion regarding the topography and structures involved and discussion and experience shared by a multidisciplinary team of surgeons with different perspectives on the area. The purpose of the surgery (biopsy, decompression, or radical removal) and the route and technique applied, consider these factors mentioned and the diagnostic suspicion of the disease.

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References

  1. Hayek G, Mercier P, Fournier HD. Anatomy of the orbit and its surgical approach. Adv Tech Stand Neurosurg. 2006;31:35–71.

    Article  CAS  PubMed  Google Scholar 

  2. Lee RP, Khalafallah AM, Gami A, Mukherjee D. The lateral orbitotomy approach for intraorbital lesions. J Neurol Surg B Skull Base. 2020;81(4):435–41.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hu S, Colley P. Surgical orbital anatomy. Semin Plast Surg. 2019;33(2):85–91.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bejjani GK, Cockerham KP, Kennerdel JS, Maroon JC. A reappraisal of surgery for orbital tumors. Part I: Extraorbital approaches. Neurosurg Focus. 2001;10(5):E2.

    Article  CAS  PubMed  Google Scholar 

  5. Engin Ö, Adriaensen GFJPM, Hoefnagels FWA, Saeed P. A systematic review of the surgical anatomy of the orbital apex. Surg Radiol Anat. 2021;43(2):169–78.

    Google Scholar 

  6. Maroon JC, Kennerdell JS. Surgical approaches to the orbit. Indications and techniques. J Neurosurg. 1984;60(6):1226–35.

    Article  CAS  PubMed  Google Scholar 

  7. Shields JA, Shields CL, Scartozzi R. Survey of 1264 patients with orbital tumors and simulating lesions: the 2002 montgomery lecture, part 1. Ophthalmology. 2004;111(5):997–1008.

    Article  PubMed  Google Scholar 

  8. Abussuud Z, Ahmed S, Paluzzi A. Surgical approaches to the orbit: a neurosurgical perspective. J Neurol Surg B Skull Base. 2020;81(4):385–408.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Locatelli D, Dallan I, Castelnuovo P. Surgery around the orbit: how to select an approach. J Neurol Surg B Skull Base. 2020;81(4):409–21.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Abou-Al-Shaar H, Krisht KM, Cohen MA, Abunimer AM, Neil JA, Karsy M, et al. Cranio-orbital and Orbitocranial approaches to orbital and intracranial disease: eye-opening approaches for neurosurgeons. Front Surg. 2020;7:1.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Pai SB, Nagarjun MN. A neurosurgical perspective to approaches to the orbit: a cadaveric study. Neurol India. 2017;65(5):1094–101.

    Article  PubMed  Google Scholar 

  12. Kannan S, Hasegawa M, Yamada Y, Kawase T, Kato Y. Tumors of the orbit: case report and review of surgical corridors and current options. Asian J Neurosurg. 2019;14(3):678–85.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Shorr N, Baylis HI, Goldberg RA, Perry JD. Transcaruncular approach to the medial orbit and orbital apex. Ophthalmology. 2000;107(8):1459–63.

    Article  CAS  PubMed  Google Scholar 

  14. Bernardini FP, Nerad J, Fay A, Zambelli A, Cruz AAV. The revised direct Transconjunctival approach to the orbital floor. Ophthalmic Plast Reconstr Surg. 2017;33(2):93–100.

    Article  PubMed  Google Scholar 

  15. Harris GJ, Logani SC. Eyelid crease incision for lateral orbitotomy. Ophthalmic Plast Reconstr Surg. 1999;15(1):9–16; discussion 16–8.

    Article  CAS  PubMed  Google Scholar 

  16. Felippu A, Mora R, Guastini L, Peretti G. Transnasal approach to the orbital apex and cavernous sinus. Ann Otol Rhinol Laryngol. 2013;122(4):254–62.

    Article  PubMed  Google Scholar 

  17. Pant H, Bhatki AM, Snyderman CH, Vescan AD, Carrau RL, Gardner P, et al. Quality of life following endonasal skull base surgery. Skull Base. 2010;20(1):35–40.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Castelnuovo P, Dallan I, Locatelli D, Battaglia P, Farneti P, Tomazic PV, et al. Endoscopic transnasal intraorbital surgery: our experience with 16 cases. Eur Arch Otorhinolaryngol. 2012;269(8):1929–35.

    Article  PubMed  Google Scholar 

  19. Udhay P, Bhattacharjee K, Ananthnarayanan P, Sundar G. Computer-assisted navigation in orbitofacial surgery. Indian J Ophthalmol. 2019;67(7):995–1003.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Bleier BS, Healy DY, Chhabra N, Freitag S. Compartmental endoscopic surgical anatomy of the medial intraconal orbital space. Int Forum Allergy Rhinol. 2014;4(7):587–91.

    Article  PubMed  Google Scholar 

  21. Healy DY, Lee NG, Freitag SK, Bleier BS. Endoscopic bimanual approach to an intraconal cavernous hemangioma of the orbital apex with vascularized flap reconstruction. Ophthalmic Plast Reconstr Surg. 2014;30(4):e104–6.

    Article  PubMed  Google Scholar 

  22. Bleier BS, Castelnuovo P, Battaglia P, Turri-Zanoni M, Dallan I, Metson R, et al. Endoscopic endonasal orbital cavernous hemangioma resection: global experience in techniques and outcomes. Int Forum Allergy Rhinol. 2016;6(2):156–61.

    Article  PubMed  Google Scholar 

  23. Schmidt BL, Pogrel MA, Hakim-Faal Z. The course of the temporal branch of the facial nerve in the periorbital region. J Oral Maxillofac Surg. 2001;59(2):178–84.

    Article  CAS  PubMed  Google Scholar 

  24. Davidge KM, van Furth WR, Agur A, Cusimano M. Naming the soft tissue layers of the temporoparietal region: unifying anatomic terminology across surgical disciplines. Neurosurgery. 2010;67(3 Suppl Operative):ONS120–9; discussion ONS129–30.

    PubMed  Google Scholar 

  25. Salas E, Ziyal IM, Bejjani GK, Sekhar LN. Anatomy of the frontotemporal branch of the facial nerve and indications for interfascial dissection. Neurosurgery. 1998;43(3):563–8; discussion 568–9.

    Article  CAS  PubMed  Google Scholar 

  26. Dolenc VV. Microsurgical anatomy and surgery of the central skull base. Vienna: Springer; 2003. http://public.ebookcentral.proquest.com/choice/publicfullrecord.aspx?p=3069327.

    Book  Google Scholar 

  27. Vidal CHF, Nicácio JA, Hahn Y, Caldas Neto SS, Coimbra CJ. Tentorial peeling: surgical extradural navigation to protect the temporal lobe in the focused combined transpetrosal approach. Oper Neurosurg (Hagerstown). 2020;19(5):589–98.

    Article  PubMed  Google Scholar 

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Vidal, C.H.F. et al. (2023). Surgical Anatomy of the Orbit . In: Figueiredo, E.G., Rabelo, N.N., Welling, L.C. (eds) Brain Anatomy and Neurosurgical Approaches . Springer, Cham. https://doi.org/10.1007/978-3-031-14820-0_22

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  • DOI: https://doi.org/10.1007/978-3-031-14820-0_22

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