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Title: Is orbital floor a reliable and useful surgical landmark in endoscopic endonasal surgery?: A systematic review
Authors: Abdullah, B
Chuen, C.S
Husain, S
Snidvongs, K
Wang, D.Y 
Keywords: anatomic landmark
anterior ethmoidal artery
anterior skull base
carotid artery
computer assisted tomography
endoscopic endonasal surgery
maxillary sinus
optic nerve
orbital floor
paranasal sinus
skull base
systematic review
Issue Date: 2018
Citation: Abdullah, B, Chuen, C.S, Husain, S, Snidvongs, K, Wang, D.Y (2018). Is orbital floor a reliable and useful surgical landmark in endoscopic endonasal surgery?: A systematic review. BMC Ear, Nose and Throat Disorders 18 (1) : 11. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Background: The orbital floor is considered as an important intraoperative reference point in endoscopic sinonasal surgery. The aim of this review is to evaluate its reliability and usefulness as a surgical landmark in endoscopic endonasal surgery. Methods: A literature search was performed on electronic databases, namely PUBMED. The following keywords were used either individually or in combination: orbital floor; maxillary sinus roof; endoscopic skull base surgery; endoscopic sinus surgery. Studies that used orbital floor as a landmark for endoscopic endonasal surgery were included in the analysis. In addition, relevant articles were identified from the references of articles that had been retrieved. The search was conducted over a period of 6 months between 1st June 2017 and 16th December 2017. Results: One thousand seven hundred forty-three articles were retrieved from the electronic databases. Only 5 articles that met the review criteria were selected. Five studies of the orbital floor (or the maxillary sinus roof) were reviewed, one was a cadaveric study while another 4 were computed tomographic study of the paranasal sinuses. All studies were of level III evidence and consists of a total number of 948 nostrils. All studies showed the orbital floor was below the anterior skull base irrespective of the populations. The orbital floor serves as a guide for safe entry into posterior ethmoids and sphenoid sinus. Conclusions: The orbital floor is a reliable and useful surgical landmark in endoscopic endonasal surgery. In revision cases or advanced disease, the normal landmarks can be distorted or absent and the orbital floor serves as a reference point for surgeons to avoid any unintentional injury to the skull base, the internal carotid artery and other critical structures. © 2018 The Author(s).
Source Title: BMC Ear, Nose and Throat Disorders
ISSN: 14726815
DOI: 10.1186/s12901-018-0060-5
Rights: Attribution 4.0 International
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