Introduction: A deep understanding of the orbit, the structures within it, and the complex spatial relationships among these structures, bears relevance in a variety of surgical and anatomical disciplines. The anatomy beneath the periorbita is a fragile and complex network of neurovascular architectures flanked by a series of muscular and glandular structures. As a result, surgical interventions in the orbit are among the more challenging cases encountered by neurosurgeons. The purpose of this study is to evaluate the operative exposure of the orbital contents obtained with an extended orbito-zygomatic approach and to describe the spatial relationships (surgical anatomy) of the various constituents of the orbit as seen through this approach. Stereoscopic photography provides a novel method for accurately representing the spatial properties of the orbit and its contents.
Methods: 8 preserved cadaveric heads (16 sides), underwent a standard fronto-orbito zygomatic approach to expose the contents of the orbit. The osteotomy was completed with removal of the anterior clinoid process and with removal of the greater and lesser sphenoidal wings. The fronto-orbito zygomatic window and its contents were photographed at multiple angles with a stereoscopic camera system.
Results: Our study identified sequential surgical steps in approaching and dissecting the intraorbital contents. We present detailed stereoscopic photographic documentation of the orbit, revealing the complex neurovascular relationships of the intraorbital structures as seen through an orbito-zygomatic approach.
Conclusions: Our anatomical evaluation confirmed that an orbito-zygomatic osteotomy completed with extensive removal of the greater and lesser sphenoidal wings and removal of the anterior clinoid process, provides excellent exposure of the intraorbital contents. A thorough knowledge of the microsurgical anatomy as seen through this surgical perspective allows for a safer dissection of the intraorbital structures. Stereoscopic photography provides a novel method for accurately representing surgical anatomy.
Patient Care: A thorough knowledge of the microsurgical anatomy in this region will allow for safer surgical dissection of the intraorbital structures.
Learning Objectives: By the conclusion of this session, participants should be able to (1) describe the microsurgical anatomy of the orbit and (2) the fronto-orbito zygomatic approach.