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Anatomy of endoscope-assisted surgery through endonasal transsphenoidal approach to the petrous apex

Clinical neurosurgery(2013)

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摘要
Objective To study the anatomy of endoscope-assisted surgery through endonasal transsphenoidal approach to the petrous apex.Methods Ten cadaveric heads were used to simulate the endoscope-assisted surgery through endonasal transsphenoidal approach to the petrous apex.The important anatomical structures were measured.Results The procedure could be divided into three stages,i.e.,nasal stage,sphenoid sinus stage and petrous apex stage.To find out and open the anterior sphenoidal wall was the key step during the nasal stage.The optic nerve protuberance,the internal carotid artery protuberance,the optic-carotico recess(OCR) and the clivus recess could be served as constant anatomical landmarks of the anterior sphenoidal wall.There existed a circle with a diameter of 10 mm whose center was the midpoint of the line between the median the internal carotid artery protuberance,and we could safely and accurately reach the petrous apex region within the circle.Conclusion The OCR and the clivus recess are the constant anatomical structures through which we can safely and accurately manage the lesions within the petrous apex region.
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Nasal Anatomy
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