World Neurosurg
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Review Comparative Study
Comparative analysis of surgical freedom and angle of attack of two minimal-access endoscopic transmaxillary approaches to the anterolateral skull base.
Surgical freedom and the angle of attack influence approach selection for open cranial base approaches, but these concepts have not been well studied in minimal-access endoscopic approaches. We therefore developed a methodology to study surgical freedom and angle of attack in two endoscopic transmaxillary transpterygoid approaches, the endonasal ipsilateral uninostril medial maxillotomy and the sublabial Caldwell-Luc anterior maxillotomy. ⋯ We have successfully developed a model for comparing endoscopic skull base approaches. Both the endonasal medial maxillotomy approach and Caldwell-Luc approach provided endoscopic access to each target. However, the sublabial Caldwell-Luc approach offered greater surgical freedom and a more head-on approach than the endonasal medial maxillotomy. These differences in surgical freedom and angles of attack may be useful to consider when planning minimal-access approaches.