Anatomía endoscópica de la unidad estructural Fisura orbitaria inferior - Músculo de Müller en la Junción órbito selar medial y su importancia quirúrgica

Juan Carlos De Battista; Carlos Federico Buonanotte; Gustavo A. Foa Torres; Jeffrey Thomas Keller; Cesar I. Aranega

doi:10.31053/1853.0605.v74.n4.17043

Authors

Juan Carlos De Battista Hospital Privado Centro Medico Universitario de Córdoba
Carlos Federico Buonanotte Facultad de Ciencias Médicas de la UNC. Doctorado en Medicina y Cirugía de la FCM de la UNC
Gustavo A. Foa Torres Facultad de Ciencias Médicas de la UNC. Doctorado en Medicina y Cirugía de la FCM de la UNC Instituto Oulton de Córdoba.
Jeffrey Thomas Keller Universidad de Cincinnati (Instituto de neurociencia), Cincinnati, Ohio, EEUU.
Cesar I. Aranega Facultad de Ciencias Médicas de la UNC. Doctorado en Medicina y Cirugía de la FCM de la UNC

DOI:

https://doi.org/10.31053/1853.0605.v74.n4.17043

Keywords:

skull base, anatomy, endoscopy, orbit

Abstract

Background: Diseases of the orbit represent a surgical challenge, particularly those compromising the orbital apex. Optimal surgical access should provide the best possible exposure, allowing to identify certain key anatomical structures, called landmarks. Objective: Describe the endoscopic anatomy of the structural unit formed by the Inferior Orbital Fissure (IOF) and the Müller’s muscle (MM) at the orbital apex (OA), thus generating a new endoscopic anatomical landmark. Materials and methods: A bone-descriptive analysis of the IOF in dry craniums, was followed by dissection and endoscopic study of six heads (twelve sides), colored and fixed in formaldehyde. In ten dry craniums (twenty sides), distances and angles of OA foramina were measured (optic foramen [OF] and foramen rotundum [FR]). Statistical analysis was performed with SPSS 17.0 statistical software (SPSS, Inc. Chicago, IL). Results: The structural unit IOF-MM was identified in all endoscopic dissections, verifying its intimate relationship with the OA. From the morpho-metric standpoint, OF and FR were found at an average distance of 65.19 mm and 60.16 mm, respectively. The average angle of the OF was 13.32 degrees, whereas the one for FR was 19.31 degrees. We found a significant correlation between OF and FR only on the left side (left hemi-crane) (Kendall Tau b 0.69, p=0.006). There were no anatomical or morphological differences between both sides. Conclusion: The unit IOF-MM is a constant anatomical landmark, useful and safe under endoscopic technique, which allows the recognition of the OA and its contiguous areas.

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Author Biographies

Juan Carlos De Battista, Hospital Privado Centro Medico Universitario de Córdoba

Titular del servicio de neurocirugia del Hospital Privado de Cordoba.
Carlos Federico Buonanotte, Facultad de Ciencias Médicas de la UNC. Doctorado en Medicina y Cirugía de la FCM de la UNC

Titular de la Cátedra de neurología de la facultad de ciencias médicas (FCM) de la UNC. Jefe de servicio de neurología del Hospital Nacional de Clínicas de Córdoba
Gustavo A. Foa Torres, Facultad de Ciencias Médicas de la UNC. Doctorado en Medicina y Cirugía de la FCM de la UNC Instituto Oulton de Córdoba.

Titular de la Cátedra de Diagnóstico por Imágenes de la UNC. Jefe de neruoradiología diagnóstica y terapéutica del Instituto Oulton de Córdoba.
Jeffrey Thomas Keller, Universidad de Cincinnati (Instituto de neurociencia), Cincinnati, Ohio, EEUU.

Jefe del Departamento de neurocirugía de la Universidad de Cincinnati (Instituto de neurociencia), Cincinnati, Ohio, EEUU.
Co-director de la Tesis de De Battista,
Cesar I. Aranega, Facultad de Ciencias Médicas de la UNC. Doctorado en Medicina y Cirugía de la FCM de la UNC

Doctor Profesor Cesar I. Aranega director de la tesis doctoral de la UNC.

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