Superior Eyelid Transorbital Approaches: A Modular Classification System

We introduce a modular system for classifying the extensions to the superolateral eyelid endoscopic transorbital approach. This classification system divides the superior eyelid transorbital approach into two distinct categories: standard and extended. The extensions to the approach are further divided into those that widen the proximal corridor, which permit increased maneuverability, and those that widen the distal corridor, which provide access to various deep anatomic compartments. These two categories of extension work in tandem and are modular, so they can be combined in a variety of different ways, depending on the desired target. The proximal extensions consist of either the lateral orbitotomy (LO) or the superolateral orbitotomy (SLO), while the deep extensions include anterior clinoidectomy, flattening of the anterior middle fossa floor and anterior petrosectomy. This classification allows surgeons to tailor their approach based on anatomical modules that can serve as an effective tool for surgical planning, tailored to the clinical needs of each individual case.