Expanded endonasal approach: vidian canal as a landmark to the petrous internal carotid artery

Kassam, Amin; Vescan, Allan; Carrau, Ricardo L.; Prevedello, Daniel M.; Gardner, Paul A.; Mintz, Arlan; Snyderman, Carl H.; Rhoton, Albert L.

doi:10.3171/jns/2008/108/01/0177

Cited by 230 publications

(182 citation statements)

References 20 publications

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“…This 'endoscopic endonasal approach' (3,4) currently provides minimally invasive and adequate access to di erent skull base lesions. Recent anatomical studies (5)(6)(7) and clinical reports (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) have detailed and categorized this procedure into a series of anatomical modular approaches to the skull base, drawing on the pioneering, specialised and innovative work of Kassam, Carrau, and co-workers (10,(19)(20)(21) .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report

Esenat¹,

Notaris²,

Sanchez³

et al. 2013

Rhin

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Section: Introductionmentioning

confidence: 99%

Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report

Esenat¹,

Notaris²,

Sanchez³

et al. 2013

Rhin

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“…13,14 This could be identified easily from the endoscopic transpterygoid approach by dissection just medial and inferior to the maxillary nerve. Visualization of the maxillary nerve and consequently foramen rotundum could be achieved by tracing the infraorbital nerve in the roof of maxillary sinus.…”

mentioning

confidence: 99%

Clinical Correlates of the Anatomical Relationships of Foramen Ovale: A Radioanatomical Study

Youssef¹,

Carrau²,

Solares³

et al. 2014

J Neurol Surg B

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IntroductionThe infratemporal fossa (ITF) is situated beneath the floor of the middle cranial fossa, posterior to the maxillary sinus, medial to the ramus of the mandible, and lateral to the nasopharynx and pterygopalatine fossa. The greater wing of the sphenoid bone and the undersurface of the temporal bone form its roof. The lateral pterygoid plate along with the eustachian tube forms its medial wall. The deep aspect of the temporalis muscle inserting to the coronoid process, the mandibular ramus, and the temporomandibular joint (TMJ) bounds the ITF in its lateral aspect. AbstractIntroduction Endonasal endoscopic transpterygoid approaches are commonly used techniques to access the infratemporal fossa and parapharyngeal space. Important endoscopic endonasal landmarks for the poststyloid parapharyngeal space, hence the internal carotid artery, include the mandibular nerve at the level of foramen ovale and the lateral pterygoid plate. This study aims to define the anatomical relationships of the foramen ovale, establishing its distance to other important anatomical landmarks such as the pterygoid process and columella. Methods Distances between the foramen ovale, foramen rotundum, and fixed anatomical landmarks like the columella and pterygoid process were measured using computed tomography (CT) scans and cadaveric dissections of the pterygopalatine and infratemporal fossae. Results The mean distances from the foramen ovale to columella and from the foramen rotundum to columella were found to be 9.15 cm and 7.09 cm, respectively. Analysis of radiologic measurements detected no statistically significant differences between sides or gender. Conclusions The pterygoid plates and V3 are prominent landmarks of the endonasal endoscopic approach to the infratemporal fossa and poststyloid parapharyngeal space. A better understanding of the endoscopic anatomy of the infratemporal fossa and awareness of the approximate distances and geometry among anatomical landmarks facilitates a safe and complete resection of lesions arising or extending to these regions.

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“…However, these open procedures are extremely complex, traverse through major neuro-vascular structures requiring sometimes retraction of the brain with subsequent morbidity [5,6]. Recently transnasal endoscopic approaches have been reported for the resection of intra and extra-cranial lesions involving the midline skull base [1].…”

Section: Discussionmentioning

confidence: 99%

“…The ICA is of critical importance for endoscopic endonasal approaches to the petrous apex [8]. One of the key anatomical relationships that must be understood to achieve endoscopic control of the petrous carotid artery, is the relationship of the vidian canal to the anterior genu of the ICA and the surrounding foramina and fossae [6]. The vidian canal runs from the pterygopalatine fossa to the foramen lacerum and houses the vidian nerve and in 30% of cases the vidian artery is a direct branch of the ICA [7].…”

Section: Discussionmentioning

confidence: 99%

Anatomical landmarks for transnasal endoscopic skull base surgery

Sandu

Monnier

Pelletier

2011

Eur Arch Otorhinolaryngol

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Resection of midline skull base lesions involve approaches needing extensive neurovascular manipulation. Transnasal endoscopic approach (TEA) is minimally invasive and ideal for certain selected lesions of the anterior skull base. A thorough knowledge of endonasal endoscopic anatomy is essential to be well versed with its surgical applications and this is possible only by dedicated cadaveric dissections. The goal in this study was to understand endoscopic anatomy of the orbital apex, petrous apex and the pterygopalatine fossa. Six cadaveric heads (3 injected and 3 non injected) and 12 sides, were dissected using a TEA outlining systematically, the steps of surgical dissection and the landmarks encountered. Dissection done by the "2 nostril, 4 hands" technique, allows better transnasal instrumentation with two surgeons working in unison with each other. The main surgical landmarks for the orbital apex are the carotid artery protuberance in the lateral sphenoid wall, optic nerve canal, lateral optico-carotid recess, optic strut and the V2 nerve. Orbital apex includes structures passing through the superior and inferior orbital Wssure and the optic nerve canal. Vidian nerve canal and the V2 are important landmarks for the petrous apex. IdentiWcation of the sphenopalatine artery, V2 and foramen rotundum are important during dissection of the pterygopalatine fossa. In conclusion, the major potential advantage of TEA to the skull base is that it provides a direct anatomical route to the lesion without traversing any major neurovascular structures, as against the open transcranial approaches which involve more neurovascular manipulation and brain retraction. Obviously, these approaches require close cooperation and collaboration between otorhinolaryngologists and neurosurgeons.

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Expanded endonasal approach: vidian canal as a landmark to the petrous internal carotid artery

Cited by 230 publications

References 20 publications

Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report

Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report

Clinical Correlates of the Anatomical Relationships of Foramen Ovale: A Radioanatomical Study

Anatomical landmarks for transnasal endoscopic skull base surgery

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