Combined Endoscopic Endonasal Transclival and Contralateral Transmaxillary Approach to the Petrous Apex and the Petroclival Synchondrosis: Working “Around the Corner” of the Internal Carotid Artery—Quantitative Anatomical Study and Clinical Applications
Abstract
:1. Introduction
2. Materials and Methods
2.1. Anatomical Study
2.2. Surgical Technique
- (1)
- The nasal step
- (2)
- The clival step
- (3)
- The maxillary step
- (4)
- The petrosal step
2.3. Quantitative Analysis and Surgical Operability
2.4. Statistical Analysis
2.5. Surgical Series
3. Results
3.1. Anthropometric Measurements and Surgical Operability
3.2. Surgical Series
- Case 1
- Case 2
- Case 3
4. Discussion
4.1. Surgical Anatomy Considerations
4.2. Advantages and Drawbacks of the Combined EETC and CTM Approach
4.3. Surgical Considerations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Transmaxillary Corridor (Mean ± SD) | Endonasal Corridor (Mean ± SD) | p Value | |
---|---|---|---|
Angle of attack (°) | 161.1 (8.6) | 140.6 (5.7) | 0.001 |
Surgical field depth (mm) | 74.3 (4.0) | 88.0 (5.8) | 0.001 |
Petrous drilling depth (mm) | 17.2 (4.0) | 11.0 (3.3) | 0.008 |
Surgical Exposure | Surgical Maneuverability | |||
---|---|---|---|---|
0° Optics | 30° Optics | Straight Instruments | Angled Instruments | |
Transmaxillary corridor | 2 | 2 | 2 | 2 |
Endonasal corridor | 1 | 2 | 1 | 1 |
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Donofrio, C.A.; Corrivetti, F.; Riccio, L.; Corvino, S.; Dallan, I.; Fioravanti, A.; de Notaris, M. Combined Endoscopic Endonasal Transclival and Contralateral Transmaxillary Approach to the Petrous Apex and the Petroclival Synchondrosis: Working “Around the Corner” of the Internal Carotid Artery—Quantitative Anatomical Study and Clinical Applications. J. Clin. Med. 2024, 13, 2713. https://doi.org/10.3390/jcm13092713
Donofrio CA, Corrivetti F, Riccio L, Corvino S, Dallan I, Fioravanti A, de Notaris M. Combined Endoscopic Endonasal Transclival and Contralateral Transmaxillary Approach to the Petrous Apex and the Petroclival Synchondrosis: Working “Around the Corner” of the Internal Carotid Artery—Quantitative Anatomical Study and Clinical Applications. Journal of Clinical Medicine. 2024; 13(9):2713. https://doi.org/10.3390/jcm13092713
Chicago/Turabian StyleDonofrio, Carmine Antonio, Francesco Corrivetti, Lucia Riccio, Sergio Corvino, Iacopo Dallan, Antonio Fioravanti, and Matteo de Notaris. 2024. "Combined Endoscopic Endonasal Transclival and Contralateral Transmaxillary Approach to the Petrous Apex and the Petroclival Synchondrosis: Working “Around the Corner” of the Internal Carotid Artery—Quantitative Anatomical Study and Clinical Applications" Journal of Clinical Medicine 13, no. 9: 2713. https://doi.org/10.3390/jcm13092713