Characterization of Anatomical Landmarks for Exposing the Internal Carotid Artery in the Infratemporal Fossa Through an Endoscopic Transmasticator Approach: A Morphometric Cadaveric Study.
Adipose Tissue
Anatomic Landmarks
Cadaver
Carotid Artery, Internal
/ anatomy & histology
Eustachian Tube
/ anatomy & histology
Fascia
Humans
Infratemporal Fossa
/ anatomy & histology
Mandibular Nerve
/ anatomy & histology
Meningeal Arteries
/ anatomy & histology
Nasal Cavity
Natural Orifice Endoscopic Surgery
/ methods
Neuroendoscopy
/ methods
Parapharyngeal Space
/ anatomy & histology
Pterygoid Muscles
/ anatomy & histology
Sphenoid Bone
/ anatomy & histology
Endoscope
Infratemporal fossa
Internal carotid artery
Sphenoid spine
Surgical simulation
Transmasticator approach
Tympanic crest
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
06
03
2019
revised:
24
07
2019
accepted:
25
07
2019
pubmed:
4
8
2019
medline:
29
1
2020
entrez:
4
8
2019
Statut:
ppublish
Résumé
The Eustachian tube and sphenoid spine have been previously described as landmarks for endonasal surgical identification of the most distal segment of the parapharyngeal internal carotid artery (PhICA). However, the intervening space between the sphenoid spine and PhICA allows for error during exposure of the artery. In the present study, we have characterized endoscopic endonasal transmasticator exposure of the PhICA using the sphenoid spine, vaginal process of the tympanic bone, and the "tympanic crest" as useful anatomical landmarks. Endonasal dissection was performed in 13 embalmed latex-injected cadaveric specimens. Two open lateral dissections and osteologic analysis of 10 dry skulls were also performed. A novel and palpable bony landmark, the inferomedial edge of the tympanic bone, referred to as the tympanic crest, was identified, leading from the sphenoid spine to the lateral carotid canal. Additionally, the vaginal process of the tympanic bone, viewed endoscopically, was a guide to the PhICA. The sphenoid spine was bifurcate in 20% of the skulls, with an average length of 5.98 mm (range, 3.9-8.2 mm), width of 5.81 mm (range, 3.0-10.6 mm), and distance to the carotid canal of 4.48 mm (range, 2.5-6.1 mm). The sphenoid spine and pericarotid space has variable anatomy. Using an endoscopic transmasticator approach to the infratemporal fossa, we found that the closest landmarks leading to the PhICA were the tympanic crest, sphenoid spine, and vaginal process of the tympanic bone.
Sections du résumé
BACKGROUND
BACKGROUND
The Eustachian tube and sphenoid spine have been previously described as landmarks for endonasal surgical identification of the most distal segment of the parapharyngeal internal carotid artery (PhICA). However, the intervening space between the sphenoid spine and PhICA allows for error during exposure of the artery. In the present study, we have characterized endoscopic endonasal transmasticator exposure of the PhICA using the sphenoid spine, vaginal process of the tympanic bone, and the "tympanic crest" as useful anatomical landmarks.
METHODS
METHODS
Endonasal dissection was performed in 13 embalmed latex-injected cadaveric specimens. Two open lateral dissections and osteologic analysis of 10 dry skulls were also performed.
RESULTS
RESULTS
A novel and palpable bony landmark, the inferomedial edge of the tympanic bone, referred to as the tympanic crest, was identified, leading from the sphenoid spine to the lateral carotid canal. Additionally, the vaginal process of the tympanic bone, viewed endoscopically, was a guide to the PhICA. The sphenoid spine was bifurcate in 20% of the skulls, with an average length of 5.98 mm (range, 3.9-8.2 mm), width of 5.81 mm (range, 3.0-10.6 mm), and distance to the carotid canal of 4.48 mm (range, 2.5-6.1 mm).
CONCLUSION
CONCLUSIONS
The sphenoid spine and pericarotid space has variable anatomy. Using an endoscopic transmasticator approach to the infratemporal fossa, we found that the closest landmarks leading to the PhICA were the tympanic crest, sphenoid spine, and vaginal process of the tympanic bone.
Identifiants
pubmed: 31376554
pii: S1878-8750(19)32101-1
doi: 10.1016/j.wneu.2019.07.185
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e415-e424Informations de copyright
Copyright © 2019. Published by Elsevier Inc.