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| Name | Trans-cavernous Transpetrosal Approach: 3-D Demonstration in Cadavers |
| Video Uploader | Video From NEUROSURGERY Journal |
| Upload Date | This Video Uploaded At 02-07-2014 12:48:38 |
| Video Discription | Kawase's technique of extradural subtemporal trans-petrosal trans-tentorial approach is a popular middle cranial fossa approach for lesions of the petroclival region. This is one of the most commonly practiced procedures because of surgeons' familiarity and years of successful practice over the last two decades. Inappropriate handling may put several neurovascular structures at risk, because the neighborhood of the petrous apex is densely crowded with internal carotid artery (ICA), 3rd -8th cranial nerves, and cochleovestibular complex. Lesions extending into anterior cavernous sinus demand additional dissection and exposure. The authors here describe an extradural technique of exposure of the anterior petrous apex with inter-dural dissection in the lateral wall of the cavernous sinus with medial mobilization of the trigeminal nerve. It provides a larger rhomboid at the petrous apex with greater exposure of anterior and posterior cranial fossae. Extradural anterior clinoidectomy and anterior cavernous dissection is demonstrated for lesions with para-sellar and orbital extension. The limitations of this approach are increased operative time and unfamiliar anatomy especially in the region of the cavernous sinus. Potential complications include increased blood loss, CSF leak, and injury to cochlear apparatus and cranial nerves (3rd-6th). Skull base approaches warrant high competence and proficiency in the treating surgeon, as surgical risks are high and margin of error is less. The complexities of skull base anatomy and dissection must be mastered by cadaver dissection in the laboratory. This educational 3-D video of cadaver dissection and 3-D animation graphics is directed for demonstration of the pertinent anatomy and an extradural approach for the anterior petrous apex and cavernous sinus exposure. |
| Category | Science & Technology |
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