Anatomical and computed tomographic analysis of the transcochlear and endoscopic transclival approaches to the petroclival region

Mason, Eric; Rompaey, Jason Van; Carrau, R.; Panizza, Benedict; Solares, C. Arturo

doi:10.1002/lary.24378

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…Alternatively, the transnasal approach may be preferred if extensive facial nerve mobilization and/or cochlear compromise are required of a lateral approach. 10 As reported, FPCT imaging of the temporal bone can be used specifically to study the infralabyrinthine anatomy relative to the pathology of interest. Using specific landmarks and cross-sectional planes, the size and orientation of an infralabyrinthine corridor can be estimated in advance of surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The dissection also produced a significant widening of the infralabyrinthine window along the axial dimension by 0.9 to 4.5 mm or a mean of 2 mm (t ¼ 3.7; p < .05) (►Fig. 10).…”

Section: Cadaveric Studiesmentioning

confidence: 97%

“…Endonasal approaches, however, are most appropriate with abutment of the lesion against the sphenoid sinus and favorable placement of the internal carotid artery. 9,10 Transmastoid access to the petrous apex and medial structures, in contrast, is obstructed by the jugular bulb, facial nerve, labyrinth, and the petrous portion of the internal carotid artery (ICA). In a deaf ear, the translabyrinthine approach provides direct access to the petrous apex.…”

Section: Introductionmentioning

confidence: 99%

“…In a deaf ear, the translabyrinthine approach provides direct access to the petrous apex. 1 More anterior access to the petroclival junction may require mobilization of the facial nerve, transcochlear extension of the dissection, 10 and repair of a cerebrospinal fluid (CSF) leak using a fat graft.…”

Section: Introductionmentioning

confidence: 99%

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Decompression of the Jugular Bulb for Enhanced Infralabyrinthine Access to the Petroclival Region: A Quantitative Analysis

et al. 2015

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Objectives To describe an enhanced infralabyrinthine approach to petroclival lesions with jugular bulb decompression, and to quantify surgical access using a flat-panel computed tomography image protocol. Design Retrospective case series and paired comparison of pre- versus post-dissection anatomy. Setting Tertiary academic medical center. Participants Four patients presenting with petroclival lesions. Six fresh cadaveric specimens were used for temporal bone dissection. Main Outcome Measures Axial and coronal dimensions, and access angles of the infralabyrinthine surgical corridor. Results Decompression of the jugular bulb increased the craniocaudal width of the infralabyrinthine corridor from 0.9 to 7.9 mm to 6.5 to 11.6 mm. The mean increase of 4 mm was statistically significant (t = 3.7; p < .05). There was also a significant widening of the infralabyrinthine window along the axial dimension by 0.9 to 4.5 mm or a mean of 2 mm (t = 3.7; p < .05). Angles of access to the petroclival region were wider following jugular bulb decompression, particularly in the coronal plane (mean difference 7.9 degrees; t = 5.0; p < .005) but less so in the axial plane (mean difference 4.7 degrees; t = 2.5; p = .05). Conclusions Jugular bulb decompression enhances infralabyrinthine access to petroclival lesions, permitting the removal of tissue for diagnoses or partial resection, without significant additional morbidity.

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Section: Discussionmentioning

confidence: 99%

“…The dissection also produced a significant widening of the infralabyrinthine window along the axial dimension by 0.9 to 4.5 mm or a mean of 2 mm (t ¼ 3.7; p < .05) (►Fig. 10).…”

Section: Cadaveric Studiesmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Decompression of the Jugular Bulb for Enhanced Infralabyrinthine Access to the Petroclival Region: A Quantitative Analysis

et al. 2015

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“…2,3,23,24,46 Recent studies have developed an ever-expanding list of pathologies accessible endoscopically, especially through the endonasal corridor. 37,56,65 As these approaches mature, endoscopy will become a more commonly used technology to aid the neurosurgeon in the operating room, just as the microscope did a generation ago.…”

Section: Endoscopic Approachesmentioning

confidence: 99%

The history of neurosurgery and its relation to the development and refinement of the frontotemporal craniotomy

Ormond

Hadjipanayis

2014

FOC

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The history of neurosurgery is filled with descriptions of brave surgeons performing surgery against great odds in an attempt to improve outcomes in their patients. In the distant past, most neurosurgical procedures were limited to trephination, and this was sometimes performed for unclear reasons. Beginning in the Renaissance and accelerating through the middle and late 19th century, a greater understanding of cerebral localization, antisepsis, anesthesia, and hemostasis led to an era of great expansion in neurosurgical approaches and techniques. During this process, frontotemporal approaches were also developed and refined over time. Progress often depended on the technical advances of scientists coupled with the innovative ideas and courage of pioneering surgeons. A better understanding of this history provides insight into where we originated as a specialty and in what directions we may go in the future. This review considers the historical events enabling the development of neurosurgery as a specialty, and how this relates to the development of frontotemporal approaches.

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Magnetic resonance angiographic study of variations in course of paraclival and parasellar internal carotid artery in relation to expanded endonasal endoscopic approaches

Jayashankar

Patangrao

2021

Eur Arch Otorhinolaryngol

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Anatomical and computed tomographic analysis of the transcochlear and endoscopic transclival approaches to the petroclival region

Abstract: Endoscopic access to the petroclival region is a feasible approach. It potentially avoids hearing loss, facial nerve manipulation, and cosmetic damage.

Cited by 12 publications

References 21 publications

Decompression of the Jugular Bulb for Enhanced Infralabyrinthine Access to the Petroclival Region: A Quantitative Analysis

Decompression of the Jugular Bulb for Enhanced Infralabyrinthine Access to the Petroclival Region: A Quantitative Analysis

The history of neurosurgery and its relation to the development and refinement of the frontotemporal craniotomy

Magnetic resonance angiographic study of variations in course of paraclival and parasellar internal carotid artery in relation to expanded endonasal endoscopic approaches

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