Microsurgical and Endoscopic Anatomy of the Vidian Canal

Osawa, Shigeyuki; Rhoton, Albert L.; Şeker, Aşkın; Shimizu, Satoru; Fujii, Kiyotaka; Kassam, Amin

doi:10.1227/01.neu.0000338945.54863.d9

Cited by 76 publications

(106 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The first center to ossify is between foramen rotundum (FR) and foramen oval (FO) at 9 weeks of intrauterine life [18,28]. Non-fusion due to defective ossification and synchondroses can lead to osteodural defects in skull base through several mechanisms [29][30][31][32][33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

A modification of endoscopic endonasal approach for management of encephaloceles in sphenoid sinus lateral recess

El-Tarabishi

Fawaz

Sabri

et al. 2016

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Spontaneous cerebrospinal fluid leak with meningoencephaloceles in sphenoid sinus lateral recess is challenging. Transnasal visualization of this area is difficult, especially when large pneumatization is present. External approaches to this region involve aggressive surgery and are often associated with significant morbidity. The aim of this study is to assess the real effectiveness of a modification of the endoscopic endonasal approach for their management. This is a prospective case series study and was conducted at Otolaryngology department, Ain Shams University Hospitals, Cairo, Egypt. Seven patients with spontaneous cerebrospinal fluid leak with meningoencephaloceles in the sphenoid sinus lateral recess were included. Diagnosis was confirmed by: analysis for beta-2 transferrin and imaging. They were managed with endoscopic endonasal retrograde trans-sphenoid approach described in this study with multilayered reconstruction of the defect. Mean age of our patients was 40.14 ± 8.35 years; mean BMI was 36.37 ± 2.59 kg/m. Primary empty sella was present and osteodural defect was identified in superior wall of sphenoid sinus lateral recess with punched out and regular smooth edges. Mean intra-cranial pressure was (26.42 ± 3.87 mmHO) and size of defect was less than 10 mm, mean 7.85 ± 1.34. Mean-operative time was 169.28 ± 21.87 min. The mean hospital stay was 7.42 ± 1.39 days. No cerebrospinal fluid leak recurrences were observed during follow-up period that ranged from 37 to 48 months. Endoscopic endonasal retrograde trans-sphenoid approach provides a wide, safe, and direct route to the management of sphenoid sinus lateral recess cerebrospinal fluid leak.

show abstract

Section: Discussionmentioning

confidence: 99%

A modification of endoscopic endonasal approach for management of encephaloceles in sphenoid sinus lateral recess

El-Tarabishi

Fawaz

Sabri

et al. 2016

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…This nerve exits the lateral part of the anterior end of the carotid canal, passes along the upper part of the anterolateral edge of the foramen lacerum, courses through the vidian canal, and ends in the pterygopalatine ganglion in the posterior part of the pterygopalatine fossa. (Osawa et al 2009) Clinically it serves as an important landmark in endoscopic and microsurgical approaches to the cranial base, especially for the lacerum and petrosal segment of the internal carotid artery. Damage to the vidian nerve does not prevent normal mucosal reaction to colds; however, it may reduce lacrimation as measured by Schirmer's test.…”

mentioning

confidence: 99%

Endoscopic Vidian Neurectomy: The Anatomy Consideration and Preoperative Images Analysis

Su¹,

Liu²,

Wang³

2012

Computed Tomography - Clinical Applications

View full text Add to dashboard Cite

IntroductionAlthough surgery is not a primary treatment for manaing rhinitis, it can have some adjuvant benefit in patients with significant nasal congestion or poor pharmacologic response. It is usually performed by surgical approaches to the inferior turbinate, and the more aggressive procedures such as the vidian neurectomy have not been widely applied. Traditional approaches to the vidian canal necessitate larger incisions, including transseptal, transpalatal and transantral methods. These approaches are often not reliable and at the risk of injury to the abutting neurovascular structures. Pioneers in endoscopic surgery are exploring alternatives to these traditional techniques in an attempt to minimize morbidity and the lack of irrelevant incisions. The main difficulties encountered during endoscopic approach are anatomic variations such as canal wall dehiscence, intra-sphenoid septa, pneumatization degree of pterygoid process and the relationship between vidian canal and middle turbinate. Those variations will have effect in determining the surgical success rate and the related complications. Therefore, a powerful tool, in the purpose of identifying the canal location and its surrounding anatomy, is very important to guide the surgeon in preoperative assessment and intraoperative approach. Computed tomography (CT) scanning is superior for the evaluation of the bony confines of the sinonasal tract and skull base. The most minimal recesses of the sinonasal region are easily assessed and it is possible to evaluate the position and configuration of the vidian canal. That valuable information provided by imaging studies enhances the surgical feasibility and offers an alternative for treating the rhinitis. This chapter describes the use of CT images in this capacity. Growing surgical experience and evolving technology will help to advance the feasibility of endoscopic vidian neurectomy and elucidate their indications by using preoperative images.

show abstract

“…Thus, localization of the superior border of the greater palatine canal would indicate the bottom of the pterygopalatine fossa. The pterygoid canal and the nerves within it are important anatomical landmarks for surgery reaching the anterior knee of the carotid artery, the anterior internal part of the cavernous sinus and the petrous apex [17]. We usually observe the pterygopalatine ganglion on the posterior aspect of point A mentioned above.…”

Section: Discussionmentioning

confidence: 99%

A Novel Method for Three-Dimensional Analysis of Endoscopic Spatial Relationships of Pterygopalatine Fossa Structures and Associated Regions

Feng¹,

Gao²,

Jiang³

et al. 2012

ORL

View full text Add to dashboard Cite

Background: The spatial orientation rules of the important skull base structures are essential for performing endoscopic surgery. However, there is no satisfactory three-dimensional (3-D) anatomy study available to the surgeon at present. The aims of this study are to construct a new method to learn the spatial orientation of anatomical features under endoscopy and to help the surgeon establish a 3-D image of skull base structures in his mind. Methods: A modified MicronTracker navigation system was used to measure the pitch angle, direction angle and distance from the reference points to various anatomical landmarks of the pterygopalatine fossa and related structures (PPFRS) at the skull base in 10 fresh cadavers (20 sides). Results: The location data of the positions of the major landmarks were acquired and a digital model of the anatomical structures of the PPFRS was built, which can be moved, whirled or demonstrated easily. Conclusion: It is practical to measure the positions of the anatomical structures of the PPFRS with a modified binocular vision-based MicronTracker navigation system. It is a valuable exploration tool to help the surgeon establish the orientation of surgical landmarks in his mind by the 3-D parameters and model.

show abstract

Microsurgical and Endoscopic Anatomy of the Vidian Canal

Abstract: The vidian canal and nerve are important landmarks in accessing the anterior genu of the petrous carotid, anteromedial part of the cavernous sinus, and petrous apex.

Cited by 76 publications

References 32 publications

A modification of endoscopic endonasal approach for management of encephaloceles in sphenoid sinus lateral recess

A modification of endoscopic endonasal approach for management of encephaloceles in sphenoid sinus lateral recess

Endoscopic Vidian Neurectomy: The Anatomy Consideration and Preoperative Images Analysis

A Novel Method for Three-Dimensional Analysis of Endoscopic Spatial Relationships of Pterygopalatine Fossa Structures and Associated Regions

Contact Info

Product

Resources

About