title: Surgical Anatomy of the Medial Wall of the Orbit in 14 Human Cadavers.
abstract: ObjectiveThe aim of our study is to present the anatomical landmarks to perform an endoscopic endonasal approach to the medial wall of the orbit (EEAMO).Material and MethodsWe performed 14 complete nasal and orbital endoscopic dissections in 7 adult cadaveric heads.ResultsThe EEAMO provides a surgical corridor between the medial rectus muscle superiorly and the inferior rectus muscle inferiorly .The mean distance between the ethmoidal crest and medial rectus muscle was 1.5 cm (range, 1.3-1.9 cm). The width of the medial rectus muscle was 1.2 cm (range, 1-1.5 cm). The main vascular structure in this retrobulbar space was the ophthalmic artery that crosses over the optic nerve in 86% of the cases. In its intraorbital route, the anterior ethmoidal artery and the ethmoidal nerves were situated inferior to the superior oblique muscle in all cases. The posterior ethmoidal artery was found superior to it. We could identify the inferior division of the oculomotor nerve in this surgical approach.ConclusionsThe EEAMO allows adequate exposure of the space between the medial rectus muscle and the inferior rectus muscle. The location of the ethmoidal crest of the palatine bone, and its relationship with the medial rectus muscle, is a useful anatomical landmark for this surgical approach.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Juan R
authors.initials: JR
authors.lastname: Gras-Cabrerizo
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital de Sant Joan Despí Moisès Broggi de Barcelona, Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Martel-Martin
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Jacinto
authors.initials: J
authors.lastname: Garcia-Lorenzo
authors.affiliation: Department of Ophthalmology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Álvarez
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Joan R
authors.initials: JR
authors.lastname: Montserrat-Gili
authors.affiliation: Unit of Anatomy and Human Embriology, Universitat Autónoma de Barcelona, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Mirapeix-Lucas
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Humbert
authors.initials: H
authors.lastname: Massegur-Solench
keywords: endoscopic sinus surgery; optic nerve; orbital; sinus anatomy