The Quadrangular Space, Endonasal Access to the Meckel Cave: Technical Considerations and Clinical Series

Ruiz‐Valdepeñas, Eugenio Cárdenas; Julián, Juan Antonio Simal; Prat, Gustavo Pérez; Arráez, Miguel Ángel Escribano; Ambrosíani, J.; Schrader, Ignacio Martín; Moreno, Alfonso Soto; Kaen, Ariel

doi:10.1016/j.wneu.2022.03.077

Cited by 8 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…And obviously, not all these cases can eventually be considered good candidates for a TOA. Indeed, if we change perspective and check current existing medical literature, our doubts are confirmed (31, [43][44][45][46][47][48][49]. Case series on SOM are normally collected over decades and seldom include more than 50 patients.…”

Section: Ftoz and Variationsmentioning

confidence: 99%

Endoscopic-assisted transorbital surgery: Where do we stand on the scott’s parabola? personal considerations after a 10-year experience

et al. 2022

View full text Add to dashboard Cite

Transorbital approaches are genuinely versatile surgical routes which show interesting potentials in skull base surgery. Given their “new” trajectory, they can be a very useful adjunct to traditional routes, even being a valid alternative to them in some cases, and add valuable opportunities in selected patients. Indications are constantly expanding, and currently include selected intraorbital, skull base and even intra-axial lesions, both benign and malignant. Given their relatively recent development and thus unfamiliarity among the skull base community, achieving adequate proficiency needs not only a personalized training and knowledge but also, above all, an adequate case volume and a dedicated setting. Current, but mostly future, applications should be selected by genetic, omics and biological features and applied in the context of a truly multidisciplinary environment.

show abstract

Section: Ftoz and Variationsmentioning

confidence: 99%

Endoscopic-assisted transorbital surgery: Where do we stand on the scott’s parabola? personal considerations after a 10-year experience

et al. 2022

View full text Add to dashboard Cite

show abstract

“…3 Anatomical relationships of the lesion with surrounding neurovascular structures and surgeon's experience frequently influence the choice for surgical access. 4 Minimally invasive approaches may be applied in selected cases with dual or multiport corridors.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Multiportal Approaches to Meckel's Cave: A Cadaveric Study and a Three-Dimensional Anatomical Video

Salem,

Abd El-Fattah,

Ebada

et al. 2023

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

Objective This cadaveric study aims to illustrate the lateral transorbital (LTO), transantral transpterygoid (TATP), and endoscopic endonasal approaches (EEA) to Meckel's cave (MC), defining their surgical freedom, area of exposure, and advantages and limitations; thus, refining their respective indications. Design Cadaveric study. Setting The Anatomical Laboratory for Visuospatial Innovations in Otolaryngology and Neurosurgery (ALT-VISION) at the Ohio State University, Wexner Medical Center. Participants Bilateral dissections of five injected cadavers (10 sides). Main Outcome Measures Distance to targets, surgical freedom, and area of exposure provided by the EEA, TATP, and LTO approaches. Results The TATP approach provides superior surgical freedom to foramen rotundum (167.70 ± 29.762 mm). However, surgical freedom to foramen ovale was best when using the LTO approach (75.01 ± 15.773 mm). The EEA provides a superior exposure of the medial MC (mean area of 587.69 ± 38.59 mm2). The LTO and TATP approaches provide equivalent access to the lateral MC (ranging from 468.90 ± 26.98 mm2 for TATP to 650.11 ± 35.76 mm2 for the LTO approach). Combining approaches increases the area of exposure significantly (1,237.79 ± 48.41 mm2 and 1,056.59 ± 48.12 mm2 for EEA and LTO vs. EEA and TATP). Conclusion This study thoroughly emphasizes the pros and cons of the aforementioned approaches. Each approach may be applied in selected cases as a single or as part of a combined technique. However, conventional approaches are still indicated according to extent and pathology. Level of Evidence: V.

show abstract

“…3,4 The endoscopic endonasal transpterygoid approach provides a safe entry to Meckel's cave through the quadrangular space, bounded by the petrous and paraclival internal carotid artery, the sixth cranial nerve, and the maxillary nerve. [4][5][6] This anteromedial trajectory allows a direct ventral access to this region, avoiding temporal lobe retraction. Extended variants of this approach may also be used to remove lesions in the pterygopalatine, infratemporal, and middle fossae, offering a wide range of exposure for these heterogenous tumors.…”

mentioning

confidence: 99%

Endoscopic Endonasal Transpterygoid Approach for the Resection of a Meckel's Cave Trigeminal Schwannoma: 2-Dimensional Operative Video

Guinto-Nishimura,

Eguiluz-Melendez,

Sangrador-Deitos

et al. 2023

Operative Neurosurgery

View full text Add to dashboard Cite

The Quadrangular Space, Endonasal Access to the Meckel Cave: Technical Considerations and Clinical Series

Cited by 8 publications

References 24 publications

Endoscopic-assisted transorbital surgery: Where do we stand on the scott’s parabola? personal considerations after a 10-year experience

Endoscopic-assisted transorbital surgery: Where do we stand on the scott’s parabola? personal considerations after a 10-year experience

Endoscopic Multiportal Approaches to Meckel's Cave: A Cadaveric Study and a Three-Dimensional Anatomical Video

Endoscopic Endonasal Transpterygoid Approach for the Resection of a Meckel's Cave Trigeminal Schwannoma: 2-Dimensional Operative Video

Contact Info

Product

Resources

About