title: Anatomic analysis specific for the endoscopic approach to the inferior, medial and lateral orbit.
abstract: BACKGROUND
  The endoscopic approaches to the medial and inferior orbital walls have continued to grow in popularity. The ability to provide a safe approach to the orbit through this technique has been described in a handful of studies. Even though metric analyses have been conducted on orbital anatomy, few have outlined the anatomical relations pertinent to endoscopic surgery. The goal is to provide improved understanding of the complex anatomy encountered through anatomical dissections and metric analysis of the orbit. This information could assist in approach selection during preoperative planning.
  
  
  METHODS
  Anatomical dissections via transantral and endonasal approaches were used to define the limits with current endoscopic sinus surgery instrumentation. The surface area was then calculated of the floor and medial wall to assess access created by the approaches. The path of the infraorbital canal was conducted to assess its placement within the orbital floor.
  
  
  RESULTS
  The transantral and endonasal approaches to the orbit provided an adequate surgical window inferiorly and medially. This was confirmed by the surface area calculations. Access laterally was also possible, however, it became limited as dissection advanced superior to the lateral rectus muscle. The infraorbital canal was located consistently at midline on the orbital floor.
  
  
  CONCLUSIONS
  Endoscopic access to the medial and inferior parts of the orbit is feasible and creates adequate access with current instrumentation. Knowing the surgical boundaries and the amount of exposure created can assist the surgeon in deciding a minimally invasive approach.
authors.affiliation: Georgia Skull Base Surgery Center, Department of Otolaryngology, Georgia Regents University School of Medicine , Augusta, Georgia , USA and.
authors.forename: Jason
authors.initials: J
authors.lastname: Van Rompaey
authors.forename: Carrie
authors.initials: C
authors.lastname: Bush
authors.forename: C Arturo
authors.initials: CA
authors.lastname: Solares
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D009915:Orbit / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D009916:Orbital Diseases / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult