Posterior Skull Base Imaging: Anatomy and Pathology for the Skull Base Surgeon

Objective: The posterior skull base can house a range of pathologic processes that can extend beyond the skull base, both intracranially and caudally. These pathologies can be broadly subdivided into neoplastic, vascular, infectious or trauma-related. Understanding the complex anatomy and imaging features of posterior skull base lesions are important for the skull base surgeon to understand how best to guide management.

Purpose: The purpose of this abstract is to highlight normal anatomy and pathology of the posterior skull base and present cross sectional imaging review of the pathologies that may be encountered by the skull base surgeon.

Methods: We performed a retrospective search of our radiology database using the Nuance mPower search engine for cases involving the posterior skull base from 2010 to 2021. Both CT and MRI images and clinical information from EHR were reviewed.

Results: CT and MRI are used as complementary methods to analyze the posterior skull base. Multiple imaging examples were used in this pictorial essay to illustrate the relevant anatomy and pathology of the posterior skull base for clinical and surgical management.

Conclusion: Imaging plays an essential role in the diagnosis and management of posterior skull base pathologies. Understanding normal anatomy, its variations and pathology of the posterior skull base can be critically important in the clinical and surgical management of the patient ([Figs. 1] and [2]).[1]-[5]

Fig. 1 Coronal CT in bone window shows a well-defined tubular lesion extending from the jugular foramen region into the middle ear cavity anterior to the cochlear promontory.

Fig. 2 Coronal MRA MIP image shows a more laterally located and diminutive left ICA consistent with an aberrant ICA. Knowledge of anatomic variants and imaging findings are important to prevent unnecessary or fatal (biopsy) management.

Publikationsverlauf

Artikel online veröffentlicht:
15. Februar 2022

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