Giuliano Silveira-Bertazzo1,2, Rafael Martinez-Perez3, Ricardo L Carrau3,4, Daniel M Prevedello5,6. 1. Department of Neurological Surgery, The Ohio State University Medical Center, N-1049 Doan Hall, 410 West 10th. Avenue, Columbus, OH, 43210, USA. Giubertazzo@hotmail.com. 2. Department of Neurosurgery, University of Joinville Region, and Neurological and Neurosurgical Clinic of Joinville, Joinville, SC, Brazil. Giubertazzo@hotmail.com. 3. Department of Neurological Surgery, The Ohio State University Medical Center, N-1049 Doan Hall, 410 West 10th. Avenue, Columbus, OH, 43210, USA. 4. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA. 5. Department of Neurological Surgery, The Ohio State University Medical Center, N-1049 Doan Hall, 410 West 10th. Avenue, Columbus, OH, 43210, USA. dprevedello@gmail.com. 6. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA. dprevedello@gmail.com.
Abstract
BACKGROUND: Superb knowledge of anatomy and techniques to remove the natural barriers preventing full access to the most lateral aspect of the skull base determines the ease of using the transpterygoid approach (ETPA) as the main gateway for all the coronal planes during endonasal surgeries. METHODS: Throughout stepwise image-guided cadaveric dissections, we describe the surgical anatomy and nuances of the ETPA to the pterygopalatine fossa (PPF) and upper parapharyngeal space (UPPS). CONCLUSION: The ETPA represents a lateral extension of the midline corridor and provides a valuable route to access the PPF/UPPS. Major landmarks for this EEA are the infraorbital canal, sphenopalatine foramen, and vidian nerve. It comprises the removal of the palatine bone, posterior wall of the maxillary sinus, and PPF transposition to drill the pterygoid process.
BACKGROUND: Superb knowledge of anatomy and techniques to remove the natural barriers preventing full access to the most lateral aspect of the skull base determines the ease of using the transpterygoid approach (ETPA) as the main gateway for all the coronal planes during endonasal surgeries. METHODS: Throughout stepwise image-guided cadaveric dissections, we describe the surgical anatomy and nuances of the ETPA to the pterygopalatine fossa (PPF) and upper parapharyngeal space (UPPS). CONCLUSION: The ETPA represents a lateral extension of the midline corridor and provides a valuable route to access the PPF/UPPS. Major landmarks for this EEA are the infraorbital canal, sphenopalatine foramen, and vidian nerve. It comprises the removal of the palatine bone, posterior wall of the maxillary sinus, and PPF transposition to drill the pterygoid process.
Entities:
Keywords:
EEA; Infratemporal fossa; Parasagittal, muscles of mastication, pterygoid muscle, Eustachian tube, postyloid compartment; Pterygopalatine fossa, expanded endonasal; Skull base surgery; Transpterygoid; Upper parapharyngeal space
Authors: Matteo Zoli; Giacomo Sollini; Fulvio Zaccagna; Viscardo Paolo Fabbri; Lorenzo Cirignotta; Arianna Rustici; Federica Guaraldi; Sofia Asioli; Caterina Tonon; Ernesto Pasquini; Diego Mazzatenta Journal: Int J Environ Res Public Health Date: 2022-05-25 Impact factor: 4.614