What is the best route to the Meckel cave? Anatomical comparison between the endoscopic endonasal approach and a lateral approach

Van Rompaey, Jason, Bush, Carrie, Khabbaz, Eyad, Vender, John, Panizza, Ben and Solares, C. Arturo (2013) What is the best route to the Meckel cave? Anatomical comparison between the endoscopic endonasal approach and a lateral approach. Journal of Neurological Surgery, Part B: Skull Base, 74 6: 331-336. doi:10.1055/s-0033-1342989

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Author Van Rompaey, Jason
Bush, Carrie
Khabbaz, Eyad
Vender, John
Panizza, Ben
Solares, C. Arturo
Title What is the best route to the Meckel cave? Anatomical comparison between the endoscopic endonasal approach and a lateral approach
Journal name Journal of Neurological Surgery, Part B: Skull Base   Check publisher's open access policy
ISSN 2193-6331
2193-634X
Publication date 2013-12-01
Year available 2013
Sub-type Article (original research)
DOI 10.1055/s-0033-1342989
Volume 74
Issue 6
Start page 331
End page 336
Total pages 6
Place of publication New York, NY, United States
Publisher Thieme Medical Publishers
Language eng
Subject 2728 Clinical Neurology
Formatted abstract
Background: Traditionally, a pterional approach is utilized to access the Meckel cave. Depending on the tumor location, extradural dissection of the Gasserian ganglion can be performed. An endoscopic endonasal access could potentially avoid a craniotomy in these cases.

Methods: We performed an endoscopic endonasal approach as well as a lateral approach to the Meckel cave on six anatomic specimens. To access the Meckel cave endoscopically, a complete sphenoethmoidectomy and maxillary antrostomy followed by a transpterygoid approach was performed. For lateral access, a pterional craniotomy with extradural dissection was performed.

Results: The endoscopic endonasal approach allowed adequate access to the Gasserian ganglion. All the relevant anatomy was identified without difficulty. Both approaches allowed for a similar exposure, but the endonasal approach avoided brain retraction and improved anteromedial exposure of the Gasserian ganglion. The lateral approach provided improved access posterolaterally and to the superior portion.

Conclusion: The endoscopic endonasal approach to the Meckel cave is anatomically feasible. The morbidity associated with brain retraction from the open approaches can be avoided. Further understanding of the endoscopic anatomy within this region can facilitate continued advancement in endoscopic endonasal surgery and improvement in the safety and efficacy of these procedures. 
Keyword Endonasal endoscopic
Gasserian ganglion
Lateral approach
Maxillary antrostomy
Meckel cave
Pterional craniotomy
Sphenoethmoidectomy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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Created: Tue, 10 Dec 2013, 10:22:51 EST by System User on behalf of School of Medicine