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Enoloscopic anatomy of the endonasal transmaxillary transpterygoid approach to Meckel’s cave
GU Ye ZHANG Xiao-biao*WANG Xue-jianYU Yong HU FanXU Wen-long XIE Tao SUN Chong-jing
Acta Anatomica Sinica ›› 2014, Vol. 45 ›› Issue (1) : 89-93.
Enoloscopic anatomy of the endonasal transmaxillary transpterygoid approach to Meckel’s cave
Objective To investigate anatomic characteristics of an endoscopic endonasal transmaxillary transpterygoid approach to Meckel’s cave, which included searching significant anatomic landmarks and obtaining relevant anatomic measurements. To establish an anatomic basis for clinical applications of endoscopic endonasal transmaxillary transpterygoid approach to Meckel’s cave. Methods Five adult fresh head specimens (10 sides) were investigated to identify important anatomic landmarks. The distances between the landmarks in the endoscopic endonasal transmaxillary transpterygoid approach to Meckel’s cave were measured during the anatomic procedure. Imaging navigation system (IGS) was employed. Results The distances from columella nasi (NC) to choana, sphenoid ostium (SO), anterior aperture of palatosphenoidal canal (PSC), sphenopalatine foramen (SPF), and the anterior aperture of vidian canal (VC) were(66.5±3.3) mm, (61.2±1.6) mm, (64.6±1.4) mm, (62.8±2.3) mm, and (75.4±3.3) mm, respectively. The distances from anterior aperture of VC to anterior aperture of PSC and foramen rotundum (FR) were (2.1±0.7) mm and (7.5±0.7) mm. The lengths of PSC and VC were (6.4±0.5) mm and (13.3±1.2) mm. The anterior aperture of VC was identified via finding PSC. VC was considered a landmark to the anterior genu of petrous internal carotid (ICA). Paraclival ICA was be identified by paraclival carotid prominence (CP). Imaging navigation system (IGS) helped identifying anatomical landmarks and guiding anatomic manipulating. Conclusion Fully exposure of Meckel’s cave via the endoscopic endonasal transmaxillary transpterygoid approach is feasible. The approach enters into anterior Meckel’s cave through a quadrangular space, which is bordered medially and inferiorly by ICA, laterally by maxillary nerve, and superiorly by the abducens cranial nerve. The data from the experiment and IGS is useful to locate crucial anatomical landmarks.
Endoscopy / Meckel’s cave / Vidian canal / Palatosphenoidal canal / Foramen rotundum / Anatomy / Adult
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