Background: The transorbital approaches (TOAs) have acquired growing notoriety, thanks to their ability to offer alternative corridors to the skull base. However, the limited access and the unfamiliarity with this surgical perspective make recognition of key landmarks difficult, especially for less experienced surgeons. The study wants to offer a detailed description of the anatomy to comprehend the potential and limitations of TOAs. Methods: Measurements of the orbit region and the surrounding areas were performed on two hundred high-resolution CT scans and thirty-nine dry skulls. Five specimens were dissected to illustrate the TOA, and one was used to perform the extradural clinoidectomy. Three clinical cases highlighted the surgical applications. Results: A step-by-step description of the key steps of the TOA was proposed and a comparison with the transcranial anterior clinoidectomy was discussed. The mean work distance was 6.1 ± 0.4 cm, and the lateral working angle increased 20 ± 5.4° after removing the lateral orbital rim. Conclusions: TOAs are indicated in selected cases when tumor involves the lateral portion of the cavernous sinus or the middle skull base, obtaining a direct decompression of the optic nerve and avoiding excessive manipulation of the neurovascular structures. Comprehension of surgical anatomy of the orbit and its surrounding structures is essential to safely perform these approaches.
背景：经眶入路因其能为颅底手术提供替代通道而日益受到关注。然而，由于手术视野受限及对该视角的陌生感，关键解剖标志的识别较为困难，尤其对于经验不足的外科医生。本研究旨在通过详尽的解剖描述，阐明经眶入路的优势与局限。方法：基于200例高分辨率CT扫描及39例干燥颅骨标本，对眼眶及周边区域进行测量分析。通过解剖5例标本演示经眶入路操作步骤，其中1例用于实施硬膜外床突切除术，并结合3例临床病例说明其手术应用。结果：研究系统阐述了经眶入路的关键步骤，并与经颅前床突切除术进行对比分析。测量数据显示平均操作距离为6.1±0.4厘米，切除眶外侧缘后外侧操作角度可增加20±5.4°。结论：对于累及海绵窦外侧部或中颅底的特定病例，经眶入路能实现视神经直接减压，并避免过度牵拉神经血管结构。掌握眼眶及周边区域的外科解剖知识是安全实施该入路的重要前提。
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