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

Kenichi Oyama; Yudo Ishii; Shigeyuki Tahara; Takehiro Watanabe; Toshio Hirohata; Makoto Katsuno; Daniel M. Prevedello; Ricardo L. Carrau; Sebastien Froelich; Akio Morita; Akira Matsuno

doi:10.1055/s-0037-1600721

Journal of Neurological Surgery Part B: Skull Base, Inhaltsverzeichnis

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

Autoren

Kenichi Oyama

¹Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
Yudo Ishii

¹Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
Shigeyuki Tahara

²Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
Takehiro Watanabe

¹Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
Toshio Hirohata

¹Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
Makoto Katsuno

¹Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan
Daniel M. Prevedello

³Department of Neurological Surgery, The Ohio State University, Columbus, Ohio, United States
Ricardo L. Carrau

⁴Department of Otolaryngology The Ohio State University, Columbus, Ohio, United States
Sebastien Froelich

⁵Department of Neurosurgery, Lariboisière Hospital, Paris VII-Diderot University, Paris, France
Akio Morita

²Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
Akira Matsuno

¹Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan

Abstract

Volltext

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.