Impact of removal of the lateral orbital rim on intraorbital pressure during endoscopic trans-orbital approach (ETOA): a cadaveric study
Bibliographic record
Abstract
BACKGROUND: The endoscopic transorbital approach (ETOA) is being established as a new corridor for the lateral portion of the anterior and middle skull base. One of the main concerns is the risk of ophthalmological complications due to orbital retraction. Removal of the lateral orbital rim (LOR) is a simple measure that widens the corridor and may diminish injuries secondary to retraction. This study analyzes the impact of LOR removal on intraorbital pressure (IORP) during the stages of ETOA. METHODS: In this prospective cadaveric study, standard ETOA to the anterior and middle fossae were performed via a superior eyelid crease incision (Fig. 2). On one side, the LOR was preserved; on the other, it was removed. IORP was recorded with an intracranial pressure (ICP) probe during the entirety procedure (Fig. 3). All specimens underwent pre- and post-procedure CT to measure bone removal volume. RESULTS: Four specimens were used (8 sides, 4 with LOR removal, 4 without). Mean IORP was not statistically different between groups during periorbita detachment, which was prior to LOR removal (117.4 vs 91.5 mmHg, for the LOR removal group and LOR intact group respectively p = 0.217). IORP was consistently reduced in the LOR removal group in every subsequent step (Fig. 3): meningo-orbital band cutting (105.5 to 38.9 mmHg, p < 0.002), temporal fossa drilling (85.3 to 69.5 mmHg, p = 0.232), lateral greater sphenoid wing (GSW) drilling (99.8 to 49.9 mmHg, p < 0.001), medial GSW drilling (85.6 to 17.2 mmHg, p < 0.001), cavernous sinus peeling (85.6 to 3.0 mmHg, p < 0.001). LOR removal increased total bone removal volume from 6.2 cc to 9.4 cc (p = 0.05). CONCLUSION: LOR removal decreased IORP, especially when working on the GSW and cavernous sinus, and significantly increased bone removal. These results support LOR removal to reduce orbital retraction stress and widen the working corridor during ETOA.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".