Petrous carotid canal dehiscence: an anatomic and radiographic study.
Publication/Presentation Date
10-1-2008
Abstract
HYPOTHESIS: Development of the osseous petrous carotid canal is frequently incomplete.
BACKGROUND: Although dehiscence of the carotid canal has been observed in previous studies, the frequency and extent of bony dehiscence have not been quantified. Inadvertent internal carotid artery injury occurs in 3 to 5% of skull base procedures, with an additional 1.9% of patients having carotid artery vasospasm. Documentation of the incidence of petrous apex carotid canal dehiscence is therefore warranted.
METHODS: Ninety-nine cadaveric skulls were evaluated physically and by computed tomographic scan.
RESULTS: Incidence of dorsal (endocranial) dehiscence of the petrous carotid canal was identified in 82.83% of the left side and 88.89% of the right side. Average dimensions for left dorsal dehiscence measured 10.81 mm longitudinally by 4.10 mm transversely. Dimensions for the right averaged 11.59 mm longitudinally by 4.29 mm transversely. Incidence of ventral (exocranial) dehiscence was less frequent: 37.37% on the left and 34.34% on the right. Ventral dehiscence was classified into major (absence of bone) and minor (fissure) types. Major dehiscence was observed in 8.08% and 6.06% of specimens for left and right sides, respectively; minor ventral dehiscence was present in 29.29% and 28.28% for left and right sides, respectively.
CONCLUSION: Dorsal petrous carotid canal dehiscence is more common than previously recognized. Dehiscence of the dorsal carotid canal is a frequent finding with significant implications in advanced skull base approaches to the petrous apex, clivus, and lateral sellar compartment. Ventral dehiscence is a frequent finding that will become increasingly relevant as the scope of endoscopic skull base procedures.
Volume
29
Issue
7
First Page
1001
Last Page
1004
ISSN
1537-4505
Published In/Presented At
Hearst, M. J., Kadar, A., Keller, J. T., Choo, D. I., Pensak, M. L., & Samy, R. N. (2008). Petrous carotid canal dehiscence: an anatomic and radiographic study. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 29(7), 1001–1004. https://doi.org/10.1097/MAO.0b013e31818599ea
Disciplines
Medicine and Health Sciences
PubMedID
18716566
Department(s)
Department of Surgery, Division of Otolaryngology
Document Type
Article