Infraorbital Nerve: A Road Map to the Pterygopalatine Fossa, Cavernous Sinus, and Skull Base in Endoscopic Transmaxillary Approaches

Abstract

Introduction: Endoscopic transmaxillary approaches are becoming more commonly performed for pathology of the anterolateral skull base, including the cavernous sinus, pterygopalatine fossa, and infratemporal fossa. This is an anatomically complex region which contains branches of the trigeminal nerve, external carotid artery, and is in close proximity to the internal carotid artery. Intraoperatively, we have found the infraorbital nerve (ION) located within the roof maxillary sinus to be an easily identifiable landmark that leads to the skull base. In this study, we sought to study the anatomy of the ION and describe its relationship to other neurovascular structures encountered in endoscopic transmaxillary approaches.