The anatomy of the parapharyngeal segment of the internal carotid artery for endoscopic endonasal approach

Fang, Xiang; Di, Guangfu; Zhou, Wei; Jiang, Xiaochun

doi:10.1007/s10143-019-01176-3

Cited by 6 publications

(5 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The stylopharyngeal muscle was anterior to the carotid sheath and was a reliable landmark for locating the lower part of the parapharyngeal segment of the ICA, which is consistent with a previous publication. 35 The external orifice of carotid canal was posterior to the attachment site of the levator veli palatini muscle on the inferior surface of the petrosal pyramid, which was a helpful landmark for the parapharyngeal segment of the ICA. As the retropharyngeal lymph node was adjacent to the medial surface of the parapharyngeal segment of the ICA, the enlarged retropharyngeal lymph node itself could be used as a landmark for the parapharyngeal segment of the ICA.…”

Section: Discussionmentioning

confidence: 99%

Anatomical studies and early results on endoscopic transoral medial pterygomandibular fold approach to salvage retropharyngeal lymphadenectomy in nasopharyngeal carcinoma

Xue,

Liu,

Liu

et al. 2023

J. Laryngol. Otol.

View full text Add to dashboard Cite

Objective Retropharyngeal lymphadenectomy is challenging. This study investigated a minimally invasive approach to salvage retropharyngeal lymphadenectomy in patients with nasopharyngeal carcinoma. Methods An anatomical study of four fresh cadaveric heads was conducted to demonstrate the relevant details of retropharyngeal lymphadenectomy using the endoscopic transoral medial pterygomandibular fold approach. Six patients with nasopharyngeal cancer with retropharyngeal lymph node recurrence, who underwent retropharyngeal lymphadenectomy with the endoscopic transoral medial pterygomandibular fold technique at the Eye and ENT Hospital of Fudan University from July to December 2021, were included in this study. Results The anatomical study demonstrated that the endoscopic transoral medial pterygomandibular fold approach offers a short path and minimally invasive approach to the retropharyngeal space. The surgical procedure was well tolerated by all patients, with no significant post-operative complications. Conclusion The endoscopic transoral medial pterygomandibular fold approach is safe and efficient for retropharyngeal lymphadenectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Anatomical studies and early results on endoscopic transoral medial pterygomandibular fold approach to salvage retropharyngeal lymphadenectomy in nasopharyngeal carcinoma

Xue,

Liu,

Liu

et al. 2023

J. Laryngol. Otol.

View full text Add to dashboard Cite

show abstract

“…36 Obviously, the rule of thumb is to prevent these injuries by proper training and operator experience, using the "2 surgeons, 4 hands" method, and having a good grasp of patientspecific anatomy utilizing the best preoperative imaging techniques. 30,[37][38][39][40][41][42][43] Anatomical considerations in EES must be kept in the mind to avoid this serious complication. [44][45][46] However, ICA injury may still occur in the best of hands, 47 and apart from exsanguination, this injury may lead to a diverse range of vascular findings such as pseudoaneurysms, arterial spasm, arterial thrombosis/emboli, and caroticocavernous fistula formation.…”

Section: Discussionmentioning

confidence: 99%

Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase

et al. 2021

View full text Add to dashboard Cite

Internal carotid artery (ICA) injury is a catastrophic complication of endoscopic endonasal surgery (EES). However, its standard management, emergent endovascular treatment, may not always be available, and the transnasal approach may be insufficient to achieve hemostasis.A 44-year-old woman with pituitary adenoma underwent EES complicated with the ICA cavernous segment injury (CSI). In urgent intraoperative angiogram, a good collateral flow from the contralateral carotid circulation was observed. Due to the unavailability of intraoperative embolization, emergent surgical trapping was performed by combined transcranial and cervical approach. The patient recovered but later developed a giant cavernous pseudoaneurysm. During the pseudoaneurysm embolization, ICA was directly accessed via a 1.7-F puncture hole using a bare microcatheter technique. Then, both the aneurysm and parent artery were obliterated with coils. At the 4-year follow-up, the patient was asymptomatic without a residual tumor. To our knowledge, this is the first case of ICA–CSI during EES successfully treated with ICA trapping as a lifesaving urgent surgery that achieved a complete recovery after a pseudoaneurysm embolization. Although several studies reported that EES-related ICA–CSIs with percutaneous carotid artery access, neither our surgical salvage technique nor our carotid access and tract embolization techniques were previously described.

show abstract

“…The internal carotid artery (ICA) is the most feared structure by endoscopic surgeons for its complications in skull base surgeries. In particular, there is a lack of anatomical landmarks that allow the safe exposure of the cervical portion of the ICA, which is surrounded by soft tissues throughout the parapharyngeal area in infratemporal fossa and access to this segment of the ICA is less de ned [3,7]. In endoscopic transpterygoid approach, the pterygoid plate, mandibular nerve, Eustachian tube, and styloid process have been reported as reliable landmarks for reaching the parapharyngeal ICA [2].…”

Section: Introductionmentioning

confidence: 99%

“…Technological advancements have signi cantly expanded the range of areas accessible through endoscopic approaches in skull base surgeries, but the complications attributed to these approaches have also increased proportionally [3]. The internal carotid artery (ICA) is the most feared structure by endoscopic surgeons for its complications in skull base surgeries.…”

Section: Introductionmentioning

confidence: 99%

Investigation of Sphenoid Spine Morphometry for Skull Base Surgery and Relation to Foramen Spinosum Localization

Ipek,

Ozustun,

Akdogan

2024

Preprint

View full text Add to dashboard Cite

Purpose Our study aimed to investigate the sphenoid spine morphological characterization, as well as the distances to important surgical points and its relation to foramen spinosum localization. Methods On a total of 65 skulls, the distances of the sphenoid spine to articular tubercle, mastoid process, external opening of carotid canal, anterior edge of infratemporal crest, and the point where sphenosquamosus suture intersects with infratemporal crest were measured from both the right and left sides. The length of the sphenoid spine was measured and classified morphologically. Localization of foramen spinosum relation to sphenoid spine was evaluated. Results The sphenoid spine length was stastistically different which was found to be 6.71 ± 1.97 and 6.14 ± 1.93 on the rigt and left sides, respectively (p = 0.027). The most commonly encountered shape of the sphenoid spine on both sides was rectangular, followed by spine shape. The foramen spinosum was most frequently located anteromedially and least frequently located anterolaterally according to sphenoid spine. In our study, it was determined for the first time that the localization of the foramen spinosum is associated with the shape of the sphenoid spine on both the right (p = 0.012) and left (p = 0.016) sides. Conclusion Our study provides morphometric data on the sphenoid spine and reports the association between the localization of the foramen spinosum and the type of sphenoid spine. Sphenoid spine variations and their relationship with adjacent anatomical structures should be taken into consideration in middle cranial fossa surgeries.

show abstract

The anatomy of the parapharyngeal segment of the internal carotid artery for endoscopic endonasal approach

Cited by 6 publications

References 20 publications

Anatomical studies and early results on endoscopic transoral medial pterygomandibular fold approach to salvage retropharyngeal lymphadenectomy in nasopharyngeal carcinoma

Anatomical studies and early results on endoscopic transoral medial pterygomandibular fold approach to salvage retropharyngeal lymphadenectomy in nasopharyngeal carcinoma

Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase

Investigation of Sphenoid Spine Morphometry for Skull Base Surgery and Relation to Foramen Spinosum Localization

Contact Info

Product

Resources

About