Lifeng Li1,2, Nyall R London2,3,4, Daniel M Prevedello2,5, Ricardo L Carrau2,5. 1. Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China. 2. Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio. 3. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland. 4. Sinonasal and Skull Base Tumor Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland. 5. Department of Neurological Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio.
Abstract
BACKGROUND: The anterolateral triangle enclosed by the foramen rotundum and foramen ovale constitutes part of the floor of the middle cranial fossa (MCF). OBJECTIVE: To assess the feasibility of a transnasal prelacrimal approach for accessing the floor of MCF via an anterolateral triangle corridor and to determine the extent of maximal exposure while safeguarding neurovascular structures. METHODS: A transnasal prelacrimal approach was performed in 5 cadaveric specimens (10 sides). Following the identification of foramen rotundum and foramen ovale, the bony ridge between 2 was drilled to expose the MCF. The temporal lobe dura was then elevated laterally, and the distances from foramen ovale to the respective borders of the area of the MCF window were measured using a surgical navigation device. RESULTS: The MCF was exposed with a 0° scope in all specimens also exposing significant landmarks including the middle meningeal artery, greater superficial petrosal nerve, superior petrous sinus, and arcuate eminence. Average distances from foramen ovale to the anterior, posterior, and lateral exposed borders were 22.86 ± 1.87 mm, 27.24 ± 0.94 mm, and 24.23 ± 1.61 mm, respectively. The average area of exposed MCF window was 554.12 ± 60.22 mm2. Preservation of vidian nerve, greater palatine nerve, lateral nasal wall, and nasolacrimal duct was possible in all 10 sides. CONCLUSION: It is feasible to access the floor of MCF via an endoscopic transnasal prelacrimal approach with seemingly low risk.
BACKGROUND: The anterolateral triangle enclosed by the foramen rotundum and foramen ovale constitutes part of the floor of the middle cranial fossa (MCF). OBJECTIVE: To assess the feasibility of a transnasal prelacrimal approach for accessing the floor of MCF via an anterolateral triangle corridor and to determine the extent of maximal exposure while safeguarding neurovascular structures. METHODS: A transnasal prelacrimal approach was performed in 5 cadaveric specimens (10 sides). Following the identification of foramen rotundum and foramen ovale, the bony ridge between 2 was drilled to expose the MCF. The temporal lobe dura was then elevated laterally, and the distances from foramen ovale to the respective borders of the area of the MCF window were measured using a surgical navigation device. RESULTS: The MCF was exposed with a 0° scope in all specimens also exposing significant landmarks including the middle meningeal artery, greater superficial petrosal nerve, superior petrous sinus, and arcuate eminence. Average distances from foramen ovale to the anterior, posterior, and lateral exposed borders were 22.86 ± 1.87 mm, 27.24 ± 0.94 mm, and 24.23 ± 1.61 mm, respectively. The average area of exposed MCF window was 554.12 ± 60.22 mm2. Preservation of vidian nerve, greater palatine nerve, lateral nasal wall, and nasolacrimal duct was possible in all 10 sides. CONCLUSION: It is feasible to access the floor of MCF via an endoscopic transnasal prelacrimal approach with seemingly low risk.
Authors: N McLaughlin; D Bresson; L F S Ditzel Filho; R L Carrau; D F Kelly; D M Prevedello; A B Kassam Journal: Minim Invasive Neurosurg Date: 2012-01-25
Authors: Amin B Kassam; Daniel M Prevedello; Ricardo L Carrau; Carl H Snyderman; Paul Gardner; Shigeyuki Osawa; Askin Seker; Albert L Rhoton Journal: Neurosurgery Date: 2009-03 Impact factor: 4.654
Authors: Jacob L Freeman; Raghuram Sampath; Steven Craig Quattlebaum; Michael A Casey; Zach A Folzenlogen; Vijay R Ramakrishnan; A Samy Youssef Journal: J Neurosurg Date: 2017-07-21 Impact factor: 5.115
Authors: Lifeng Li; Nyall R London; Samuel Silva; Daniel Prevedello; Ricardo L Carrau Journal: Int Forum Allergy Rhinol Date: 2019-07-01 Impact factor: 3.858
Authors: Pornthep Kasemsiri; C Arturo Solares; Ricardo L Carrau; J Drew Prosser; Daniel M Prevedello; Bradley A Otto; Matthew Old; Amin B Kassam Journal: Laryngoscope Date: 2013-04 Impact factor: 3.325
Authors: Jose F Carrillo; Bernardo Rivas Leon; Miguel A Celis; Sergio Ponce-de-Leon; Francisco J Ochoa-Carrillo Journal: Am J Otolaryngol Date: 2004 Jan-Feb Impact factor: 1.808