Anatomy of the Inferior Orbital Fissure: Implications for Endoscopic Cranial Base Surgery

• Autores: de Battista, Juan Carlos; Zimmer, Lee A.; Theodosopoulos, Philip V.; Froelich, Sebastien C.; Keller, Jeffrey T.
• Año de publicación: 2012
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: ENDOSCOPE; INFERIOR ORBITAL FISSURE; ORBIT; PTERYGOPALATINE FOSSA; SKULL BASE
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

Considering many approaches to the skull base confront the inferior orbital fissure (IOF) or sphenomaxillary fissure, the authors examine this anatomy as an important endoscopic surgical landmark. In morphometric analyses of 50 adult human dry skulls from both sexes, we divided the length of the IOF into three segments (anterolateral, middle, posteromedial). Hemotoxylin- and eosin-stained sections were analyzed. Dissections were performed using transnasal endoscopy in four formalin-fixed cadaveric cranial specimens (eight sides); three endoscopic approaches to the IOF were performed.IOF length ranged from 25 to 35 mm (mean 29 mm). Length/width of the individual anterolateral, middle, and posteromedial segments averaged 6.46/5, 4.95/3.2, and 17.6/ 2.4 mm, respectively. Smooth muscle within the IOF had a consistent elationship with several important anatomical landmarks. The maxillary introstomy,total ethmoidectomy approach allowed access to the posteromedial segment of the fissure. The endoscopic modified, medial maxillectomy approach allowed access to the middle and posterior-medial segment. The Caldwell-Luc approach allowed complete exposure of the IOF. The IOF serves as an important anatomic landmark during endonasal endoscopic approaches to the skull base and orbit. Each of the three segments provides a characteristic endoscopic corridor, unique to the orbit and different fossas surrounding the fissure.
Fil: de Battista, Juan Carlos. University of Cincinnati; Estados Unidos. Universidad Nacional de Córdoba. Facultad de Medicina. Instituto de Anatomia Normal; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Zimmer, Lee A.. University of Cincinnati; Estados Unidos
Fil: Theodosopoulos, Philip V.. University of Cincinnati; Estados Unidos
Fil: Froelich, Sebastien C.. University of Cincinnati; Estados Unidos
Fil: Keller, Jeffrey T.. University of Cincinnati; Estados Unidos