Endoscopic Transnasal Approach for Deep Lateral Orbital Decompression: A Cadaver Study

Teppei Takeda; Yasine Mirmozaffari; Asha Nadabar; Jackson R. Vuncannon; Jared Martin; Adam J. Kimple; Brent A. Senior; Kazuhiro Omura; Nobuyoshi Otori; Charles Ebert; Christine Klatt-Cromwell; Brian D. Thorp

doi:10.1055/a-2565-9056

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base
DOI: 10.1055/a-2565-9056

Original Article

Endoscopic Transnasal Approach for Deep Lateral Orbital Decompression: A Cadaver Study

Authors

Teppei Takeda

¹Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan

²Department of Otolaryngology—Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
Yasine Mirmozaffari

²Department of Otolaryngology—Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
Asha Nadabar

²Department of Otolaryngology—Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
Jackson R. Vuncannon

²Department of Otolaryngology—Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
Jared Martin

²Department of Otolaryngology—Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
Adam J. Kimple

²Department of Otolaryngology—Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
Brent A. Senior

²Department of Otolaryngology—Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
Kazuhiro Omura

¹Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
Nobuyoshi Otori

¹Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
Charles Ebert

²Department of Otolaryngology—Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
Christine Klatt-Cromwell

²Department of Otolaryngology—Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
Brian D. Thorp

²Department of Otolaryngology—Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States

Abstract

Objectives

This study evaluates the anatomical feasibility of an endoscopic transnasal approach for deep lateral orbital decompression using cadaver models.

Design

Cadaver study.

Participants

Four fresh frozen cadaver heads (eight sides) were used.

Main Outcome Measures

Measurements of the sphenoid trigone before and after bone removal were assessed using CT scans. Key outcome measures included the width, height, depth, and volume of the trigone.

Results

The transnasal approach achieved a 53.9% reduction in trigone volume, with significant decreases in height (65.0%), width (84.3%), and depth (76.8%). Preoperative measurements revealed an average orbital surface width of 20.0 mm, later reduced to 16.7 mm postoperatively. The average trigone depth was reduced from 16.1 to 12.0 mm, and height decreased from 21.3 to 13.4 mm in the postoperative assessment. The procedure showed a mild limitation in reduction along the cephalocaudal axis, with residual regions measuring 4.5 and 3.0 mm in the superior and inferior directions, respectively.

Conclusion

The endoscopic transnasal approach effectively reduces the size of the sphenoid trigone, providing a promising alternative for orbital decompression with potential clinical applications. Future research should explore long-term outcomes and integration into surgical practice.

Keywords

orbital decompression - endoscopic transnasal approach - sphenoid trigone - cadaver study - orbital surgery - exophthalmos

Full Text

References

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