J Neurol Surg B Skull Base 2017; 78(S 01): S1-S156
DOI: 10.1055/s-0037-1600721
Poster Abstracts
Georg Thieme Verlag KG Stuttgart · New York

Surgical Anatomy for Endoscopic Endonasal Approach to the Ventrolateral Skull Base Lesions

Kenichi Oyama
1   Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
,
Yudo Ishii
1   Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
,
Shigeyuki Tahara
2   Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
,
Takehiro Watanabe
1   Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
,
Toshio Hirohata
1   Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
,
Makoto Katsuno
1   Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
,
Daniel M. Prevedello
3   Department of Neurological Surgery, The Ohio State University, Columbus, Ohio, United States
,
Ricardo L. Carrau
4   Department of Otolaryngology The Ohio State University, Columbus, Ohio, United States
,
Sebastien Froelich
5   Department of Neurosurgery, Lariboisière Hospital, Paris VII-Diderot University, Paris, France
,
Akio Morita
2   Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
,
Akira Matsuno
1   Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
02 March 2017 (online)

 

Background: Although it is not so difficult to get access to lesions in the midline via endoscopic endonasal approach (EEA), it is a bit troublesome to reach lesions in the lateral skull base due to some complicated anatomy.

Objective: To show surgical anatomy for EEA to the ventrolateral skull base lesions.

Method: Cadaveric heads were dissected using the endoscope. Surgical techniques were applied to clinical cases.

Results: To get access to the upper lateral skull base (cavernous sinus, orbit), simple opening of ethmoid sinus via uninostril approach provide sufficient exposure of this area. To reach the inferior lateral skull base (petrous apex, parapharyngeal space, and condyle), transpterygoid approach is the key procedure providing wide exposure of this area. To get to the infratemporal fossa, endoscopic Denker’s approach, followed by dissection around the lateral pterygoid plate is a feasible technique for accurate opening of this area.

Conclusion: Understanding of surgical anatomy is mandatory for treating the ventrolateral skull base lesions via EEA. Less invasive and appropriate approach should be applied depending on the size, location, and type of the lesion.