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This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project PI19/00592 and cofunded by the European Union; it has also been funded by the Fundacio La Marato de TV3 (Reg. 95/210; Codi projecte 201914).

Analysis of institutional authors

Sanchez Lorenzo, JulioAuthorDi Somma ACorresponding AuthorSánchez JcAuthorAlobid IAuthorFerrés AAuthorRoldán PAuthorEnseñat JAuthorPrats-Galino AAuthor

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September 21, 2022
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Endoscopic transorbital avenue to the skull base: Four-step conceptual analysis of the anatomic journey

Publicated to:Frontiers In Oncology. 12 988131- - 2022-09-02 12(), DOI: 10.3389/fonc.2022.988131

Authors: Guizzardi, Giulia; Di Somma, Alberto; de Notaris, Matteo; Corrivetti, Francesco; Carlos Sanchez, Juan; Alobid, Isam; Ferres, Abel; Roldan, Pedro; Reyes, Luis; Ensenat, Joaquim; Prats-Galino, Alberto

Affiliations

European Biomed Res Inst Salerno EBRIS Fdn, European Biomed Res Inst Salerno, Lab Neurosci, Salerno, Italy - Author
Hosp Clin Barcelona, Clin Inst Ophthalmol ICOF, Barcelona, Spain - Author
Hosp Clin Barcelona, Dept Neurol Surg, Barcelona, Spain - Author
Hosp Clin Barcelona, ENT Dept, Rhinol Unit, Barcelona, Spain - Author
Hosp Clin Barcelona, ENT Dept, Smell Clin, Barcelona, Spain - Author
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Serv Invest Anat Func Sistema Nervioso, Barcelona, Spain - Author
San Pio Hosp, Dept Neurosci, Neurosurg Operat Unit, Benevento, Italy - Author
Univ Barcelona, Lab Surg Neuroanat, Barcelona, Spain - Author
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Abstract

In the last decades, skull base surgery had passed through an impressive evolution. The role of neuroanatomic research has been uppermost, and it has played a central role in the development of novel techniques directed to the skull base. Indeed, the deep and comprehensive study of skull base anatomy has been one of the keys of success of the endoscopic endonasal approach to the skull base. In the same way, dedicated efforts expended in the anatomic lab has been a powerful force for the growth of the endoscopic transorbital approach to the lateral skull base.Therefore, in this conceptual paper, the main steps for the anatomic description of the endoscopic transorbital approach to the skull base have been detailed.The anatomic journey for the development of the endoscopic transorbital approach to the skull base has been analyzed, and four "conceptual" steps have been highlighted.As neurosurgeons, the eyeball has always represented a respectful area: to become familiar with this complex and delicate anatomy, we started by examining the orbital anatomy on a dry skull (step 1). Hence, step 1 is represented by a detailed bone study; step 2 is centered on cadaveric dissection; step 3 consists in 3D quantitative assessment of the novel endoscopic transorbital corridor; and finally, step 4 is the translation of the preclinical data in the real surgical scenario by means of dedicated surgical planning.The conceptual analysis of the anatomic journey for the description of the endoscopic transorbital approach to the skull base resulted in four main methodological steps that should not be thought strictly consequential but rather interconnected. Indeed, such steps should evolve following the drives that can arise in each specific situation. In conclusion, the four-step anatomic rehearsal can be relevant for the description, diffusion, and development of a novel technique in order to facilitate the application of the endoscopic transorbital approach to the skull base in a real surgical scenario.Copyright © 2022 Guizzardi, Di Somma, de Notaris, Corrivetti, Sánchez, Alobid, Ferres, Roldan, Reyes, Enseñat and Prats-Galino.

Keywords

anteriorcavernous sinusendoscopic skull base surgeryendoscopic transorbital anatomyfeasibilitylesionspetrous apexrouteskull base anatomysurgerysurgical planningArticleDiffusionDissectionEndonasal approachEndoscopic skull base surgeryEndoscopic transorbitalEndoscopic transorbital anatomyEyeballHumanNeurosurgeonPreclinical studyQuantitative analysisRespectSkullSkull base anatomySkull surgerySurgical planning

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Frontiers In Oncology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 85/241, thus managing to position itself as a Q2 (Segundo Cuartil), in the category Oncology. Notably, the journal is positioned en el Cuartil Q2 para la agencia Scopus (SJR) en la categoría Oncology.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 4.57, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-06, the following number of citations:

  • WoS: 6
  • Scopus: 7
  • Europe PMC: 3

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-06:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 18.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 18 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 5.
  • The number of mentions on the social network X (formerly Twitter): 7 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Italy.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (Prats Galino, Albert).

the author responsible for correspondence tasks has been Di Somma, Alberto.