TY - JOUR
T1 - A systematic review of the surgical anatomy of the orbital apex
AU - Engin, null
AU - Adriaensen, G. F. J. P. M.
AU - Hoefnagels, F. W. A.
AU - Saeed, P.
N1 - Publisher Copyright: © 2020, The Author(s).
PY - 2021/2
Y1 - 2021/2
N2 - Purpose: The orbital apex is the narrowest part of the orbit, housing the link between the intracranial cavity and orbit. Knowledge of orbital apex anatomy is crucial to selecting a surgical approach and reducing the risk of complications. Our purpose is to summarize current knowledge on surgical anatomy and attempt to reach a consensus on definition of the orbital apex. Methods: The online databases of Embase, the Cochrane library, Web of Science and PubMed (MEDLINE) were queried in a comprehensive bibliographic search on the (surgical) anatomy of the orbital apex and consisted of a combination of two subjects, using indexed terms and free text: “Orbital Apex” and “Orbital Anatomy.” Results: A total of 114 relevant papers were included in this review. Numerous anatomical variations are described in the literature. Variations of the optic canal include duplication (0.64%) and keyhole anomaly (2.65%). Variations in pneumatization of the anterior clinoid process were unilateral in almost 10%, bilateral in 9%, and normal in 72%. A rare variant of the superior orbital fissure (SOF) is Warwick’s foramen, which appears as if the lowest portion of the SOF was separated from the main fissure by a transverse bony bridge. Conclusion: The definition of the orbital apex varies in the literature, and further research would most likely identify additional variations. A universal definition reporting these variations and pathology and imaging findings is essential for determining the optimal surgical approach to the orbital apex.
AB - Purpose: The orbital apex is the narrowest part of the orbit, housing the link between the intracranial cavity and orbit. Knowledge of orbital apex anatomy is crucial to selecting a surgical approach and reducing the risk of complications. Our purpose is to summarize current knowledge on surgical anatomy and attempt to reach a consensus on definition of the orbital apex. Methods: The online databases of Embase, the Cochrane library, Web of Science and PubMed (MEDLINE) were queried in a comprehensive bibliographic search on the (surgical) anatomy of the orbital apex and consisted of a combination of two subjects, using indexed terms and free text: “Orbital Apex” and “Orbital Anatomy.” Results: A total of 114 relevant papers were included in this review. Numerous anatomical variations are described in the literature. Variations of the optic canal include duplication (0.64%) and keyhole anomaly (2.65%). Variations in pneumatization of the anterior clinoid process were unilateral in almost 10%, bilateral in 9%, and normal in 72%. A rare variant of the superior orbital fissure (SOF) is Warwick’s foramen, which appears as if the lowest portion of the SOF was separated from the main fissure by a transverse bony bridge. Conclusion: The definition of the orbital apex varies in the literature, and further research would most likely identify additional variations. A universal definition reporting these variations and pathology and imaging findings is essential for determining the optimal surgical approach to the orbital apex.
KW - Anatomy
KW - Apex
KW - Orbit
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85094813440&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00276-020-02573-w
DO - https://doi.org/10.1007/s00276-020-02573-w
M3 - Article
C2 - 33128648
SN - 0930-1038
VL - 43
SP - 169
EP - 178
JO - Surgical and Radiologic Anatomy
JF - Surgical and Radiologic Anatomy
IS - 2
ER -