Medical Student Presenter: Sonam Dodhia
Institution: Columbia University Department of Otolaryngology – Head and Neck Surgery,
Title: Landmarks in endonasal endoscopic orbital surgery
Scientific Oral Presentation
Mentor: David A. Gudis, MD
Outcome objective: Recently, the endonasal endoscopic approach to the orbit has progressed as an alternative to traditional external orbital approaches. Familiarity with intraorbital neurovascular and muscular anatomy is critical to safe and successful surgery. The objective of this study is to provide a systematic review and meta-analysis of the literature to establish key intraorbital structures as they relate to sinonasal landmarks.
Methods: Literature searches were performed independently by the two study authors according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify articles that evaluate intraorbital anatomic landmarks as they relate to sinonasal structures. Individual study quality was assessed with the Methodological Index for Non-Randomized Studies (MINORS) scale. Raw data from individual studies were consolidated and weighted averages and composite ranges were calculated for a meta-analysis.
Results: Twelve studies were included in this review. Among the key measurements are, at the coronal level of the basal lamella, a vertical diameter of the medial rectus of 8.2 + 0.7 mm [6.2-11.1], and distances from the medial orbital floor to the medial rectus of 4.0 + 1.4 mm [0-7.7] and to the inferior rectus of 2.6 + 1.7 mm [-1.3-7.4]. The optic nerve lies 11.8 + 2.2 mm [5.6-23] from the medial orbital floor at the coronal level of the basal lamella, and 3.2 + 0.9mm [0.6-6.0] at the coronal level of the anterior wall of the sphenoid sinus.
Conclusions: This systematic review and meta-analysis identifies several key anatomic landmarks to facilitate safe endonasal endoscopic orbital surgery.