Microsurgical Anatomy Study Of The Frontotemporal Orbitozygomatic Approach To Orbital Apex Region

To provide a anatomical basis for the clinical operative approach to treat the tumors in cranio-orbital region,eight cases(16 sides) of adult cadaver heads fixed by 10%formalin were performed with the one-piece frontotemporal orbitozygomatic (FTOZ1) approach.Meanwhile the important anatomy structures about this approach and the orbital apex region were observed and analyzed.PartⅠ:The applied anatomy of the frontotemporal orbitozygomatic approachObjective:The FTOZ1 approach were performed and the important anatomy structures about this approach were observed and analyzed to provide a anatomical basis for the clinical operative approach.Material and Methods:The FTOZ1 approach were performed on eight(16 sides) adult cadaver heads fixed by 10%formalin(arterial system has been primed with red latex).Then operated and measured with the anatomical layers to find a clear relationship between this adjacent anatomical structures.The related anatomy structures with the FTOZ1 approach like supraorbital pore-related(or supraorbital notch),zygoma,inferior orbital fissure,MacCarty Keyhole were observed and measured.Results:The FTOZ1 approach becomes relatively simple and safe when the MacCarty key-hole used in orbital osteotomy and the superolateral part of inferior orbital fissure used in orbital osteotomy and zygomatic arch osteotomy.PartⅡ:The microsurgical study of the orbital apexObjective:To provide detailed anatomy basis for treat cranio-orbital tumors in clinical,the orbital region was microanatomy and find the anatomy structures through this region. To find the safety methods to exposure the superolateral part of the superior orbital fissure,incise the tendinous annulus of Zinn in the central part of the superior orbital fissure and the best way to exposure the orbital apex in greatest.Material and Methods:Eight(16 sides) adult cadaver heads fixed by 10%formalin(arterial system has been primed with red latex) were selected.Then dissect the orbital apex with the microsurgical technique to study the important structure like the tendinous annulus of Zinn as well as nerve,blood vessel distribution.Results:The tendinous annulus of Zinn attached to the superior,medial,inferior wall and bone penetration in the midpoint of the superior orbital fissure lateral wall.It is enveloping the cranial hole of the optic canal and some structures through the superior orbital fissure.The superior orbital fissure was distinguish by it into three department. The nerves and blood vessels through the orbital apex were very tight and the location was usually constant.So be familiar with the microanatomy of this region is important to avoid neurovascular injury.Conclusions:1.Understand how to use MacCarty key-hole and the inferior orbital fissure the key to success in FTOZ1 approach.2.The FTOZ1 approach was good to exposure the lateral and central part of the superior orbital fissure.It is important to improve the surgical treatment the tumors in cranio-orbital region. 3.The structures in the orbital apex are complex.And the nerves and blood vessels through this region are tight.It is important to understand the anatomy of this region for treat tumors in cranial-orbital region with operation.