Anatomical Study Of The Neuroendoscope Assisted Medial Orbital Approach To The Orbital Apex Region

Objective: In this study,through the simulation of the endoscope through the medial orbital approach to the orbital apex of the anatomical study,for the clinical treatment of orbital apex region,anterior skull base lesions,orbital cranial lesions provide anatomical parameters and morphological basis.And further explore the advantages and disadvantages of the surgical approach,feasibility,indications.Methods:9 formalin fixed in 10% formaldehyde intact adult cadaveric head specimens were fixed in cadaveric head.The full flush of arteriovenous system,with red and blue latex complete arterial and venous system perfusion,application of hard angle endoscope(Carle Storz endoscopy)by mimicking orbital medial to the orbital apex and anterior skull base surgery,anatomical observation layer.The extent of exposure,anatomic structure,important anatomical landmarks and the distance between the anatomic landmarks were observed under endoscope.4 adult skull specimens were used to observe the bony structure,and to measure the distance between the optic canal,the orbital apex and the anterior skull base.And statistically analyze the obtained data.Results: In this study,through the observation and measurement of bone dry specimens,we can know the distance between the important bony landmarks and provide anatomical parameters for clinical operation.Through the simulation of the medial orbital apex to the orbit in the pres head specimens of surgical approach,the specimens were dissected and observed,involved in the approach of the orbital and medial orbital wall,anterior cranial fossa and orbital apex region important structures were observed.Objective to investigate the operative approach and the range of access.The optic canal cranial mouth horizontal oval shape,width and height respectively:6.24 ±1.05 mm?4.10 ± 0.68 mm.Optic canal orbital mouth in a vertical oval shape,width and height: 4.80 ± 0.84mm?5.50 ± 1.20 mm.Orbital opening walls thicker called ring,upper and lower,and wall thickness: 2.30 ± 0.90 mm?1.78 ±1.20 mm?0.66 ± 0.30 mm?6.70 ± 1.58 mm.Orbital roof,and the medial orbital diameter and medial orbital wall thickness: 54.28 ± 6.64 mm?48.60 ± 5.04 mm?0.28 ± 0.12 mm.The medial orbital distance before and after the front screen hole distance mm: 19.80 ± 3.56 mm?33.80 ± 0.84 mm.Screen after optic canal orbital hole distance from the mouth of 6.28 ± 1.64 mm.Plate length,width:18.62 ± 4.04 mm?4.96 ± 2.12 mm.From the leading edge of optic canal orbital cranial mouth distance: 49.80 ± 4.56 mm.The blind hole to sphenoid platform front distance: 32.80 ± 6.84 mm.Identification of orbital anatomy blocks,anterior ethmoidal foramen,posterior ethmoidal foramen,orbital optic nerve and anterior cranial fossa.Identification of bony landmarks: plate,olfactory fossa,comb and sphenoid platform.Endoscopic transsphenoidal approach for optic nerve protuberance,internal carotid artery segment parasella uplift,slope segment of internal carotid visual identification of neural artery eminence,carotid trigone,sphenoidal planum,saddle and slope structure.Conclusions:Based on the anatomical study of orbital apex,medial orbital wall,sphenoid sinus,ethmoid sinus,optic canal,and anterior skull base,we can have a more in-depth understanding of the relevant anatomical landmarks,the relevant anatomical data.And morphological parameters can provide more basis for the treatment of orbital lesions.It is of great significance to identify the anatomical landmarks of the sphenoid sinus under the endoscope.The carotid triangle of theoptic nerve is a very important landmark for the location of the optic nerve tube and orbital apex.Under the endoscope,it has a clear visual field and a small trauma,which can be used to better expose the anatomical structure of the surgical area and the surgical field.Consistent with the current concept of minimally invasive surgery.