{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:15:04Z","timestamp":1793042104810,"version":"4.5.0"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Combined endonasal and transorbital multiportal surgery has been recently described for selected skull base pathologies. Nevertheless, a detailed anatomic description and a quantitative comprehensive anatomic study of the skull base areas where these 2 endoscopic routes converge, a so-called connection areas, are missing in the scientific literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To identify all the skull base areas and anatomic structures where endonasal and transorbital endoscopic avenues could be connected and combined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Five cadaveric specimens (10 sides) were used for dissection. Qualitative description and quantitative analysis of each connection areas were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      At the anterior cranial fossa, the connection area was found at the level of the sphenoid planum; in the middle cranial fossa, it was at the Mullan triangle; finally, in the posterior cranial fossa, the connection area was just behind the medial portion of the petrous apex. The average extradural working areas through the transorbital approach were 4.93, 12.93, and 1.93 cm\n                      <jats:sup>2<\/jats:sup>\n                      and from the endonasal corridor were 7.75, 10.45, and 7.48 cm\n                      <jats:sup>2<\/jats:sup>\n                      at the level of anterior, middle, and posterior cranial fossae, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>The combined endonasal and transorbital endoscopic approach is an innovative entity of skull base neurosurgery. From the anatomic point of view, our study demonstrated the feasibility of this combined approach to access the entire skull base, by both corridors, identifying a working connection area in each cranial fossa. These data could be extremely useful during the surgical planning to predict which portion of a lesion could be removed through each route and to optimize patients' care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1227\/ons.0000000000000577","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T12:58:11Z","timestamp":1675083491000},"page":"e342-e350","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Multiportal Combined Endoscopic Endonasal and Transorbital Pathways: Qualitative and Quantitative Anatomic Studies of the \u201cConnection\u201d Skull Base Areas"],"prefix":"10.1227","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1603-8738","authenticated-orcid":false,"given":"Giulia","family":"Guizzardi","sequence":"first","affiliation":[{"name":"Laboratory of Surgical Neuroanatomy, Universitat de Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Prats-Galino","sequence":"additional","affiliation":[{"name":"Laboratory of Surgical Neuroanatomy, Universitat de Barcelona, Spain;"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Mosteiro","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and Spine Unit, Hospital Universitario Marqu\u00e9s de Valdecilla, Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomaz","family":"Topczewski","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Torales","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Roldan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Reyes","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3253-3448","authenticated-orcid":false,"given":"Alberto","family":"Di Somma","sequence":"additional","affiliation":[{"name":"Laboratory of Surgical Neuroanatomy, Universitat de Barcelona, Spain;"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Barcelona, Spain;"},{"name":"Department of Neurological Surgery, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim","family":"Ensen\u0303at","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1,2]]},"reference":[{"issue":"1","key":"R1-20250820","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s10143-015-0655-x","article-title":"Middle infratemporal fossa less invasive approach for radical resection of parapharyngeal tumors: surgical microanatomy and clinical application","volume":"39","author":"Nonaka","year":"2016","journal-title":"Neurosurg Rev."},{"issue":"1","key":"R2-20250820","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3171\/2015.2.JNS132876","article-title":"Quantitative analysis of the Kawase versus the modified Dolenc-Kawase approach for middle cranial fossa lesions with variable anteroposterior extension","volume":"123","author":"Tripathi","year":"2015","journal-title":"J Neurosurg."},{"key":"R3-20250820","doi-asserted-by":"crossref","first-page":"e666","DOI":"10.1016\/j.wneu.2018.01.119","article-title":"Minimally invasive approaches for anterior skull base meningiomas: supraorbital eyebrow, endoscopic endonasal, or a combination of both? 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