Endoscopic transorbital route to the petrous apex: a feasibility anatomic study
| Autor: | Alberto Prats-Galino, Thomaz E. Topczewski, Joaquim Enseñat, Federico Frio, Rosa Maria Gerardi, Paolo Cappabianca, Alberto Di Somma, Norberto Andaluz, Jose Pineda, Domenico Solari, Luigi Maria Cavallo |
|---|---|
| Přispěvatelé: | Di Somma, Alberto, Andaluz, Norberto, Cavallo, Luigi Maria, Topczewski, Thomaz E., Frio, Federico, Gerardi, Rosa Maria, Pineda, Jose, Solari, Domenico, Enseñat, Joaquim, Prats-Galino, Alberto, Cappabianca, Paolo |
| Rok vydání: | 2017 |
| Předmět: |
business.operation
Cerebellopontine Angle Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Superior eyelid approach Cadaver Image Processing Computer-Assisted Humans Medicine Trigeminal Nerve Skull Base Trigeminal nerve Oculomotor nerve business.industry Petrous Apex Dissection Trochlear nerve Cranial Nerves Endoscopic transorbital Eyelids Endoscopy Anatomy Vestibulocochlear Nerve Petrous apex Cerebellopontine angle Tentorium Skull medicine.anatomical_structure Anterior petrosectomy 030220 oncology & carcinogenesis Feasibility Studies Skull base surgery Surgery Neurology (clinical) business Orbit Transorbital 030217 neurology & neurosurgery Brain Stem Petrous Bone |
| Zdroj: | Acta Neurochirurgica. 160:707-720 |
| ISSN: | 0942-0940 0001-6268 |
| DOI: | 10.1007/s00701-017-3448-x |
| Popis: | While the subtemporal approach represents the surgical module milestone designed to reach the petrous apex, a novel ventral route, which is the superior eyelid endoscopic transorbital approach, has been proposed to access the skull base. Accordingly, we aimed to evaluate the feasibility of this route to the petrous apex, providing a qualitative and quantitative analysis of this relatively novel pathway. Five human cadaveric heads were dissected at the Laboratory of Surgical NeuroAnatomy of the University of Barcelona. After proper dissection planning, anterior petrosectomy via the endoscopic transorbital route was performed. Specific quantitative analysis, as well as dedicated three-dimensional reconstruction, was done. Using the endoscopic transorbital approach, it was possible to reach the petrous apex with an average volume bone removal of 1.33 ± 0.21 cm3. Three main intradural spaces were exposed: cerebellopontine angle, middle tentorial incisura, and ventral brainstem. The first one was bounded by the origin of the trigeminal nerve medially and the facial and vestibulocochlear nerves laterally, the second extended from the origin of the oculomotor nerve to the entrance of the trochlear nerve into the tentorium free edge while the ventral brainstem area was hardly accessible through the straight, ventral endoscopic transorbital trajectory. This is the first qualitative and quantitative anatomic study concerning details of the lateral aspect of the incisura and ventrolateral posterior fossa reached via the transorbital window. This manuscript is intended as a feasibility anatomic study, and further clinical contributions are mandatory to confirm the effectiveness of this approach, defining its possible role in the neurosurgical armamentarium. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink