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

Autor:	Salem EH; Department of Otolaryngology-Head and Neck Surgery, Mansoura University, Mansoura, Egypt.; Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center, Ohio State University, Columbus, Ohio, United States., Abd El-Fattah AM; Department of Otolaryngology-Head and Neck Surgery, Mansoura University, Mansoura, Egypt., Ebada HA; Department of Otolaryngology-Head and Neck Surgery, Mansoura University, Mansoura, Egypt., Koevering KV; Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center, Ohio State University, Columbus, Ohio, United States., Hardesty DA; Department of Neurosurgery, Wexner Medical Center, Ohio State University, Columbus, Ohio, United States., Prevedello DM; Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center, Ohio State University, Columbus, Ohio, United States.; Department of Neurosurgery, Wexner Medical Center, Ohio State University, Columbus, Ohio, United States., Al-Saddeik MAE; Department of Otolaryngology-Head and Neck Surgery, Mansoura University, Mansoura, Egypt., Carrau RL; Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center, Ohio State University, Columbus, Ohio, United States.; Department of Neurosurgery, Wexner Medical Center, Ohio State University, Columbus, Ohio, United States.
Jazyk:	angličtina
Zdroj:	Journal of neurological surgery. Part B, Skull base [J Neurol Surg B Skull Base] 2023 Sep 25; Vol. 85 (6), pp. 641-649. Date of Electronic Publication: 2023 Sep 25 (Print Publication: 2024).
DOI:	10.1055/a-2158-6037
Abstrakt:	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 mm ² ). The LTO and TATP approaches provide equivalent access to the lateral MC (ranging from 468.90 ± 26.98 mm ² for TATP to 650.11 ± 35.76 mm ² for the LTO approach). Combining approaches increases the area of exposure significantly (1,237.79 ± 48.41 mm ² and 1,056.59 ± 48.12 mm ² 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. Competing Interests: Conflict of Interest The Anatomical Laboratory for Visuospatial Innovations in Otolaryngology and Neurosurgery (ALT-VISION) at the Ohio State University, Wexner Medical Center received donations in kind from Stryker Inc., Karl-Storz Endoscopy, Zeiss Inc., Medtronic Corp, Vycor Medical, and Ono Corp., KLS Inc. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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