Extended Anterior Petrosectomy Through the Transcranial Middle Fossa Approach and Extended Endoscopic Transsphenoidal-Transclival Approach: Qualitative and Quantitative Anatomic Analysis.
Publication/Presentation Date
6-1-2020
Abstract
BACKGROUND: Petroclival tumors and ventrolateral lesions of the pons present unique surgical challenges. This cadaveric study provides qualitative and quantitative anatomic comparison for an anterior petrous apicectomy through the transcranial middle fossa (TMF) and expanded endoscopic transsphenoidal-transclival approaches.
METHODS: In 10 silicone-injected heads, the petrous apex and clivus were drilled extradurally using middle fossa and endonasal approaches. With in situ and frameless stereotactic navigation, we defined consistent points to compare working areas, bone removal volumes, approach angles, and surgical freedom.
RESULTS: Mean exposed TMF area (21.03 ± 3.46 cm
CONCLUSIONS: Expanded transclival anterior petrosectomy through the TMF approach provides an adequate corridor to lesions in the upper ventrolateral pons. The expanded endoscopic transsphenoidal-transclival approach better fits midline lesions not extending laterally beyond cranial nerve VI and C3 carotid when evaluating normal anatomic parameters.
Volume
138
First Page
405
Last Page
405
ISSN
1878-8769
Published In/Presented At
Hasanbelliu, A., Andaluz, N., Di Somma, A., Keller, J. T., Zimmer, L. A., Samy, R. N., Pensak, M. L., & Zuccarello, M. (2020). Extended Anterior Petrosectomy Through the Transcranial Middle Fossa Approach and Extended Endoscopic Transsphenoidal-Transclival Approach: Qualitative and Quantitative Anatomic Analysis. World neurosurgery, 138, e405–e412. https://doi.org/10.1016/j.wneu.2020.02.127
Disciplines
Medicine and Health Sciences
PubMedID
32145421
Department(s)
Department of Surgery, Division of Otolaryngology
Document Type
Article