By Werner Hosemann, J Fanghänel
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Extra info for A Dissection Course On Endoscopic Endonasal Sinus Surgery
Fig. 41 The periorbita (P) is incised from posterior to anterior after complete exenteration of the right ethmoid. When the posterior-toanterior incisions are joined by vertical cuts, the periorbita can be removed from the skull base to a point near the infraorbital nerve (from Hosemann 2000). Fig. 42 Ocular pressure test: if there is doubt regarding possible previous injury to the periorbita, it can be resolved by applying external pressure to the eye. Repeated pressure on the globe will induce a secondary movement of the exposed orbital tissue in the nasal cavity, which can be detected with the endoscope.
Fig. 42 Ocular pressure test: if there is doubt regarding possible previous injury to the periorbita, it can be resolved by applying external pressure to the eye. Repeated pressure on the globe will induce a secondary movement of the exposed orbital tissue in the nasal cavity, which can be detected with the endoscope. 14 Skull Base 36 A Dissection Course On Endoscopic Endonasal Sinus Surgery • Demonstrate the medial rectus muscle. • Demonstrate the canal of the vidian nerve. After identifying the sphenopalatine foramen, maximally enlarge the approach to the sphenoid sinus.
Next to it, the sagittally oriented perpendicular plate of the palatine bone forms an ethmoid crest to which the posterior part of the middle turbinate is attached. , in the middle and superior meatus (Bolger et at. 1999, Warning and Padgham 1998) (Fig. 37). The maxillary artery gives off numerous small branches while still proximal to the foramen, and it becomes the Sphenopalatine foramen Extension of the middle turbinate Fig. 36 Diagram of the medial orbital wall viewed from the lateral aspect.