Assessing the Feasibility of Selective Piezoelectric Osteotomy in Transorbital Approach to the Middle Cranial Fossa: Anatomical and Quantitative Study and Surgical Implications
Bibliographic record
Abstract
OBJECTIVE: To verify the feasibility and discuss advantages and disadvantages of a piezoelectric orbitotomy during superior eyelid endoscopic transorbital approach (SETOA). An illustrative case demonstrating the application of this novel technique is also presented. METHODS: Exoscopic/endoscopic SETOA to middle cranial fossa was performed on 5 adult specimens. The surgical corridor was created via piezoelectric orbitotomy by performing 3 selective and safe micrometric bone cuts providing a 1-piece trapezoid bone flap, which was repositioned and secured at the end of the procedure. A three-dimensional scan of the bone flap allowed us to reconstruct a three-dimensional model and calculate its volume. RESULTS: by using piezoelectric orbitotomy. Piezoelectric orbitotomy also yielded concrete surgical advantages and theoretical benefits in terms of functional and esthetic outcomes. All osteotomies were micrometric clear-cut and precise, resulting in a very thin bone gap; complete sparing of soft tissues and neurovascular structures in and around the orbit was observed. Lateral orbital wall reconstruction by replacing the bone flap was performed to mitigate the risk of enophthalmos, proptosis, cerebrospinal leakage, pseudomeningocele, and pulsatile headache, which represent significant challenges. CONCLUSIONS: Piezoelectric orbitotomy may offer a viable, selective, effective, safe alternative to high-speed drilling during SETOA, especially for patients with intra-axial pathologies, in which a watertight closure is mandatory. This procedure could prevent or decrease the risk of some of the main postoperative complications associated with standard SETOA, potentially resulting in better functional and esthetic outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".