Landmarks for endoscopic approach to the parapharyngeal internal carotid artery: A radiographic and cadaveric study

Abstract

The posterior border of the mandibular ramus and the posterolateral aspect of the pterygoid process may serve as consistent bony landmarks for identification of the ppICA.

Endoscopic endonasal nasopharyngectomy: tensor veli palatine muscle as a landmark for the parapharyngeal internal carotid artery

“…Ho et al used the posterolateral pterygoid process as a bony landmark to identify the PPICA (average distance around 2.3 cm). Their data are valuable when using the endoscopic endonasal approach to the infratemporal fossa, but the lateral pterygoid process is not routinely exposed when performing EEN.…”

Cervical‐transoral robotic nasopharyngectomy: A preclinical study

“…[11][12][13][14] However, minimally-invasive endoluminal approaches can create intraoperative situations where the visibility of critical structures and tissue handling are hampered as a consequence of the restrictive workspace. 16,17 This work was presented at the 29th Annual North American Skull Base Society Meeting in Orlando, Florida, February 2019. 15 Moreover, it is sometimes dangerous with the "inside-out" approach in salvage surgery due to the fact that the internal carotid artery (ICA) is perilously close even with the use of intraoperative Doppler ultrasound or intraoperative navigation system.…”

“…15 Moreover, it is sometimes dangerous with the "inside-out" approach in salvage surgery due to the fact that the internal carotid artery (ICA) is perilously close even with the use of intraoperative Doppler ultrasound or intraoperative navigation system. 16,17 This work was presented at the 29th Annual North American Skull Base Society Meeting in Orlando, Florida, February 2019.…”

Surgical landmarks of the nasopharyngeal internal carotid using the maxillary swing approach: A cadaveric study

“…Some teams prefer open techniques, arguing better visual control, such as the maxillary swing approach . However, both use an anterior approach and share the same major risk laterally, the internal carotid artery (ICA), which has a very close relationship with the nasopharyngeal wall . Although the intrapetrous, paraclival, and parasellar portions of the ICA have clear surgical landmarks due to their fixed position in the bony canals, the paranasopharyngeal portion, which is surrounded by soft tissue, does not have reliable surgical landmarks and is always hazardous to find.…”

“…Several authors have studied the relationship between the ICA and the nasopharynx or between the external aperture of the carotid canal and the eustachian tube using an endoscopic or a lateral approach . Some imagery studies (computed tomography [CT] scan or magnetic resonance imaging based) have measured the distance in between the ICA and anatomical landmarks . However, there is to our knowledge no cadaveric study that has measured the distance in between the ICA and the eustachian tube or nasopharyngeal lateral wall, which are easy‐to‐find structures.…”