Anatomic relationships between surgical landmarks in type b and type c infratemporal fossa approaches

Abstract

Anatomic relationships of the structures exposed in type B and C infratemporal fossa approaches were studied in 20 temporal bones. The intrapetrous carotid artery (ICA), cochlea (CH), eustachian tube (ET), foramen spinosum (FS), foramen ovale (FO) and anterior foramen lacerum (AFL) were exposed by drilling of the glenoid fossa and base of middle cranial fossa. The relationships of the ICA with the cochleariform process (CP), CH, ET, FS, FO and AFL were noted along with associated measurements. The CP was lodged at a mean distance of 9.2 mm from the ICA genu. The ET was found to intersect the ICA. The mean distance of the ICA to the CH was 1.6 mm. The carotid canal was dehiscent on its horizontal portion in 30% of the bones studied and on its vertical portion in 5%. The periarterial venous plexus was found in 70% of the bones. No obvious branch was observed emerging from the vertical portion of the ICA. The FS was found to be a canal having a mean length of 5.8 mm.

The relationship between the carotid canal and mandibular condyle: an anatomical study with application to surgical approaches to the skull base via the infratemporal fossa

“…Posteriorly, it is limited by the cervical prevertebral fascia and the underlying muscles. [8,9] Identification of the ICA within the surgical field A comprehensive knowledge of the anatomical relationship of the infrapetrous ICA and its adjacent structures is crucial (Figure 4). [9] It is often difficult in cases of pathology to recognize these structures within a surgical field.…”

“…[8,9] Identification of the ICA within the surgical field A comprehensive knowledge of the anatomical relationship of the infrapetrous ICA and its adjacent structures is crucial (Figure 4). [9] It is often difficult in cases of pathology to recognize these structures within a surgical field. [10] Tumors of the skull base with carotid artery involvement either require carotid ligation, subtotal resection or have been deemed inoperable.…”

“…The aim of the type B and type C ITF approaches is to have control of the ICA. [9,24] In ITF approaches type B and type C, the main landmarks used during manipulation of the ICA are the basal turn of the cochlea, Eustachian tube, foramen spinosum, mandibular nerve and anterior foramen lacerum. [9,25] Talebzadeh et al [26] measured a transverse distance average of 37.5 mm from the carotid artery to the zygomatic arch.…”

“…The most medial aspect of the temporomandibular joint is the most lateral aspect of the ITF. In a study performed by Aslan et al [9] to clarify the anatomic relationship between surgical landmarks in type b and type c ITF approach, the cochleariform process (CP) was used as their landmark for surgical orientation. The mean distance of the CP to the ICA genus was 9.2±1.6 mm, while the mean distance from the cochlea to the ICA was 1.6±0.9 mm.…”

“…The mean distance of the CP to the ICA genus was 9.2±1.6 mm, while the mean distance from the cochlea to the ICA was 1.6±0.9 mm. [9] Mason utilized an endoscopic approach and CT imaging, to find a mean distance to the petrous ICA of 16.34 mm from the foramen rotundum, 4.88 mm from the ovale, and 5.11 mm from the spinosum in males. For females, the values were 16.4 mm from the rotundum and 4.36 mm each from the ovale and spinosum.…”