Anatomic Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Infratemporal Fossa Approach to the Jugular Foramen.

Autor:	Dornhoffer JR; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester , Minnesota , USA., Nassiri AM; Department of Otolaryngology-Head and Neck Surgery, University of Colorado Anschutz School of Medicine, Aurora , Colorado , USA., Peris-Celda M; Department of Neurologic Surgery, Mayo Clinic, Rochester , Minnesota , USA., Leonel LC; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester , Minnesota , USA.; Department of Neurologic Surgery, Mayo Clinic, Rochester , Minnesota , USA., Carlson ML; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester , Minnesota , USA.; Department of Neurologic Surgery, Mayo Clinic, Rochester , Minnesota , USA.
Jazyk:	angličtina
Zdroj:	Operative neurosurgery (Hagerstown, Md.) [Oper Neurosurg (Hagerstown)] 2024 Apr 01; Vol. 26 (4), pp. 452-462. Date of Electronic Publication: 2023 Nov 17.
DOI:	10.1227/ons.0000000000000996
Abstrakt:	Background and Objectives: The infratemporal fossa (ITF) is a complex region bounded by the temporal bone, maxilla, sphenoid, pterygoid plates, and mandibular ramus. Containing a high density of neurovascular and musculoskeletal structures, the ITF can house a number of pathologies, and access is challenging. The ITF approach and its variations can be challenging due to complex anatomy and unfamiliarity by many surgeons. The objective of this study was to present a step-by-step 3-dimensional anatomic dissection for the classic Fisch Type A and modified ITF approach from the surgeon's perspective. Methods: Six sides of 3 formalin-fixed latex-injected specimens were dissected under microscopic magnification (JRD and AMN). Standard Fisch Type A and modified ITF approaches were performed on contralateral sides of each specimen. Representative high-quality 3-dimensional photography was performed for each key step. Results: The ITF approach affords excellent access to the posterior ITF and jugular foramen. Modifications to this approach include preservation of the ear canal and limiting facial nerve transposition, thus limiting morbidity while generally still providing sufficient access to key anatomic structures. Conclusion: The ITF approach provides access to the lateral skull base for jugular foramen paraganglioma and other lesions. Modifications of the classic Fisch Type A technique can be used to access pathologies in this region without sacrificing conductive hearing or facial nerve function. Three dimensional operatively oriented neuroanatomy dissections provide surgeons with a valuable resource for learning this complex surgical approach. (Copyright © Congress of Neurological Surgeons 2023. All rights reserved.)
Databáze:	MEDLINE
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