Impact of Orbital Rim Osteotomy on Surgical Freedom in Transorbital Endoscopic Approaches: A Cadaveric Study…

StudyOphthalmic plastic and reconstructive surgery· Jul 2026

Impact of Orbital Rim Osteotomy on Surgical Freedom in Transorbital Endoscopic Approaches: A Cadaveric Study and Novel Methodology.

Lewis R Hains, Abhiram Hiwase, Justin Henkel … Dinesh Selva

OculoplasticsStudyQ2IF 1.3

Adding a superolateral orbital osteotomy greatly increased surgical exposure area during endoscopic skull-base surgery.

Impact of Orbital Rim Osteotomy on Surgical Freedom in Transorbital Endoscopic Approaches: A Cadaveric Study and Novel Methodology.

Lewis R Hains … Dinesh Selva

Ophthalmic plastic and reconstructive surgery · Jul 2026 · Q2 in Ophthalmology

Purpose

Transorbital neuroendoscopic surgery (transorbital neuroendoscopic surgery) is an emerging minimally invasive skull-base approach.

Methods

Six fresh-frozen cadaveric specimens (11 orbits) underwent bilateral superior eyelid crease incisions and periorbital dissection to the meningo-orbital band and superior orbital fissure.

n = 11 orbits

Results

surgical working area nearly doubled versus the standard approach without the osteotomy

41.6cm2

TONES

70.38cm2

L-TONES

93.78cm2

SL-TONES

More results

Both approaches demonstrated statistically significant increases in surgical exposure area when calculated using both convex-hull and simple elliptical area (p < 0.001).

L-TONES provided 70.38 cm2 of exposure when using the convex hull.

“

Conclusion

This study presents a novel, inexpensive method of quantifying surgical exposure and demonstrates increased instrument freedom through the successive addition of lateral and superior orbitotomies during transorbital neuroendoscopic surgery dissection.

Impact of Orbital Rim Osteotomy on Surgical Freedom in Transorbital Endoscopic Approaches: A Cadaveric Study and Novel Methodology.

Impact of Orbital Rim Osteotomy on Surgical Freedom in Transorbital Endoscopic Approaches: A Cadaveric Study and Novel Methodology.

Related papers