The Origami concept simplifying Meckel’s cave anatomy: a descriptive cadaveric study.

Introduction Meckel’s cave (MC) is a dural diverticulum in the middle cranial fossa (MCF) containing the Gasserian ganglion (GG). Overall, neoplasms in MC are rare with schwannomas and meningiomas being the most common primary tumors. The density of neurovascular structures and the deep location of MC pose a challenge for surgical access. A detailed understanding of the anatomy involved is critical and frequently influence the choice for surgical access.

Method The study comprised five injected cadaveric specimens. CT scans (0.5-mm thickness slices) of the specimens were uploaded to a navigation system. Bilateral surgical dissections (10 sides) were completed using standard neurosurgical instruments and 4mm rod-lens endoscopes coupled to a high-definition camera and monitor.

Results A representative 3D volumetric model connecting points of interest in MCF into lines then triangles demonstrate different areas of exposure of MC obtained from different dissection route. Adjoining the above-mentioned triangles, five macro-regions were created through the sum of adjacent triangles.

Discussion The advent of rod-lens endoscopes and the ever-increasing experience with minimal access techniques have enabled treatment of complex cases using different alternative surgical approaches. Anatomical relationships of lesions with surrounding neurovascular structures and the surgeon’s familiarity with specific approaches greatly help decision making.

Conflict of Interest

The authors declare that they have no conflict of interest.

Publication History

Article published online:
12 May 2023