Abstract:
BACKGROUND:Endoscopic approaches to the orbit improve the ability to directly access apical lesions while minimizing manipulation of normal structures. Inferomedial orbital access is limited by the orbital process of the palatine bone (OPPB) which prevents dissection and retraction in the inferolateral vector. OBJECTIVE:The objective of this study was to examine the morphometric characteristics of the OPPB and quantify the benefit of complete resection to surgical access. METHODS:Morphometric osteologic measurements of the OPPB were performed in 59 human skulls. A radius subtended by the OPPB was calculated to generate a hemispheric dissection corridor achievable by complete resection of the OPPB. Cadaveric and live surgical dissections were then performed on 15 orbits to develop discreet endoscopic surgical landmarks which could be used to both identify the OPPB and verify complete resection. RESULTS:The mean(± SD) radius of the OPPB was 0.47 ± 0.28 cm. Complete OPPB resection provided an additional 0.36 ± 0.42 cm of surgical exposure within the inferomedial apex. Relative to the Caucasian (n = 27) skulls, the radii in the Asian (n = 27) and African (n = 5) skulls were significantly smaller (p < 0.001 and p = 0.02, respectively). CONCLUSION:The OPPB significantly limits surgical access to the inferomedial orbital apex during endoscopic approaches. Complete surgical resection of the OPPB improves surgical exposure facilitating retraction of the inferior rectus muscle and circumferential dissection of lesions within this space. Knowledge of the morphology and clinical relevance of this structure provides an opportunity to improve surgical exposure for relevant pathologic assessment and optimize endoscopic surgical outcomes.
journal_name
Ophthalmic Plast Reconstr Surgjournal_title
Ophthalmic plastic and reconstructive surgeryauthors
Mueller SK,Freitag SK,Bleier BSdoi
10.1097/IOP.0000000000000940subject
Has Abstractpub_date
2018-05-01 00:00:00pages
254-257issue
3eissn
0740-9303issn
1537-2677journal_volume
34pub_type
杂志文章abstract::This study was designed to evaluate the characteristics of human orbital fat and connective tissue. Two exenteration specimens were studied by light microscopy with special stains. Four distinct regions were identified on the basis of their connective tissue septa, which contained blood vessels and were composed of el...
journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00002341-199811000-00004
更新日期:1998-11-01 00:00:00
abstract:PURPOSE:Open repair of facial fractures may offer better outcomes than closed approaches. Advantages are inherent with direct visualization and the use of fixation devices. Yet, closed approaches are commonly favored for nasal fractures for simplicity, the avoidance of a facial scar, and because exposure to the nasal b...
journal_title:Ophthalmic plastic and reconstructive surgery
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doi:10.1097/IOP.0b013e318177f87c
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journal_title:Ophthalmic plastic and reconstructive surgery
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doi:10.1097/IOP.0000000000001002
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journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/IOP.0000000000000880
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journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/IOP.0000000000000222
更新日期:2016-03-01 00:00:00
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journal_title:Ophthalmic plastic and reconstructive surgery
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doi:10.1097/IOP.0000000000000242
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journal_title:Ophthalmic plastic and reconstructive surgery
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doi:10.1097/00002341-200201000-00013
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journal_title:Ophthalmic plastic and reconstructive surgery
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journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2020-11-04 00:00:00
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journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/IOP.0000000000000256
更新日期:2015-05-01 00:00:00
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journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/IOP.0000000000000660
更新日期:2017-01-01 00:00:00
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journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00002341-199911000-00019
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journal_title:Ophthalmic plastic and reconstructive surgery
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doi:10.1097/IOP.0000000000000016
更新日期:2014-11-01 00:00:00
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journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章,评审
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更新日期:2015-09-01 00:00:00
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更新日期:2007-09-01 00:00:00
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doi:10.1097/IOP.0b013e3181c9fdf0
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journal_title:Ophthalmic plastic and reconstructive surgery
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pub_type: 杂志文章,随机对照试验
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journal_title:Ophthalmic plastic and reconstructive surgery
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更新日期:2019-03-01 00:00:00
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journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
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journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2016-11-01 00:00:00
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pub_type: 杂志文章
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journal_title:Ophthalmic plastic and reconstructive surgery
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更新日期:2021-01-19 00:00:00
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journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/IOP.0000000000001411
更新日期:2019-11-01 00:00:00
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abstract::A 26-year-old woman with congenital lamellar ichthyosis presented with bilateral cicatricial ectropion of the upper and lower eyelids. There was severe exposure keratopathy with corneal perforation in the left eye. The generalized skin involvement necessitated the use of an alternative to correct the cicatricial ectro...
journal_title:Ophthalmic plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/IOP.0b013e3182082f4e
更新日期:2011-11-01 00:00:00