Morphometry relevant to Anterior Petrosectomy with special reference to Kawase’s Triangle

Abstract

Background and aims :The petrous apex and the middle cranial fossa is a commonly explored area in neurosurgeries and hence require a holistic approach which should include the possibility of anatomical variants and morphometric dissimilarities. Material and Methods:This morphometric study was undertaken on 91 dry adult skulls [182 petrosal apices] to analyze a number of parameters relevant to Anterior Petrosectomy [AP] via the Kawase’s Triangle [KT]. The anatomical landmarks most pertinent to Anterior Petrosectomy [Kawase's approach] were defined, recorded and validated. The findings of the study were compared with earlier workers who have employed other means of investigation viz. dry bones/CT scans or cadaveric studies . Results : The parameters undertaken for the study presented with variable values and moresoever for the surface area of the KT. This can be very logically attributed to the variant anatomy amongst races and also to the physiological status of the individual Conclusions : AP has evolved as a preferred method for approaching petroclival region and thus requires an in depth understanding. The present analysis throws significant light on certain parameters that would be helpful in making anterior petrosectomy safer. Surgeries of the skull base demand for high end precision and proficiency and thus our findings provide enhanced alertness for a better and safe procedure. A methodical approach to the area with the background knowledge of these parameters shall culminate in desired neurosurgical outcomes.

Morphometry of Glasscock’s Triangle Pertinent to the Exposure of Horizontal Intrapetrosal Segment of the Internal Carotid Artery

“…6 Studies on the different triangles have been undertaken by various authors and all have enforced upon the accurate localization of the landmarks for an ideal surgical plan. [12][13][14][15][16][17][18] It would be worthwhile to mention that computed tomography (CT)/magnetic resonance imaging (MRI) scans along with the possibility of bone remodeling should also be taken into consideration. In conclusion to the present findings, certain parameters that would be helpful in making anterior petrosectomy safer have been described.…”