Comparative Anatomical Assessment of Full vs Limited Transcavernous Exposure of the Carotid-Oculomotor Window.
Oper Neurosurg (Hagerstown)
; 22(1): e30-e34, 2022 01 01.
Article
em En
| MEDLINE
| ID: mdl-34982908
ABSTRACT
BACKGROUND:
Although the full transcavernous approach affords extensive mobilization of the oculomotor nerve (OMN) for exposure of the basilar apex and interpeduncular cistern region, this time-consuming procedure requires substantial dural dissection along the anterior middle cranial fossa.OBJECTIVE:
To quantify the extent to which limited middle fossa dural elevation affects the carotid-oculomotor window (C-OMW) surgical area during transcavernous exposure after OMN mobilization.METHODS:
Four cadaveric specimens were dissected bilaterally to study the C-OMW area afforded by the transcavernous exposure. Each specimen underwent full and limited transcavernous exposure and anterior clinoidectomy (1 procedure per side; 8 procedures). Limited exposure was defined as a dural elevation confined to the cavernous sinus. Full exposure included dural elevation over the gasserian ganglion, extending to the middle meningeal artery and lateral middle cranial fossa.RESULTS:
The C-OMW area achieved with the limited transcavernous exposure, compared with full transcavernous exposure, provided significantly less total area with OMN mobilization (22 ± 6 mm2 vs 52 ± 26 mm2, P = .03) and a smaller relative increase in area after OMN mobilization (11 ± 5 mm2 vs 36 ± 13 mm2, P = .03). The increase after OMN mobilization in the C-OMW area after OMN mobilization was 136% ± 119% with a limited exposure vs 334% ± 216% with a full exposure.CONCLUSION:
In this anatomical study, the full transcavernous exposure significantly improved OMN mobilization and C-OMW area compared with a limited transcavernous exposure. If a transcavernous exposure is pursued, the difference in the carotid-oculomotor operative corridor area achieved with a limited vs full exposure should be considered.
Texto completo:
1
Temas:
ECOS
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Aspectos_gerais
Bases de dados:
MEDLINE
Assunto principal:
Seio Cavernoso
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Procedimentos Neurocirúrgicos
Limite:
Humans
Idioma:
En
Revista:
Oper Neurosurg (Hagerstown)
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos