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Extradural anterior temporal fossa approach to the paranasal sinuses, nasal cavities through the anterolateral and anteromedial triangles: Combined microscopic and endoscopic strategy.

Publication ,  Journal Article
Watanabe, K; Passeri, T; Hanakita, S; Giammattei, L; Zomorodi, AR; Fava, A; Abbritti, R; Labidi, M; Champagne, PO; Fukushima, T; Froelich, S
Published in: Acta Neurochir (Wien)
August 2021

OBJECTIVE: To demonstrate the utility and limitations of the extradural endoscopic-assisted anterior temporal fossa approach to the pterygopalatine fossa (PPF), infratemporal fossa (ITF), paranasal sinuses (PS), parapharyngeal region (PPR), nasal cavities (NC), epipharynx (EP), and clivus. METHODS: A frontotemporal orbitozygomatic craniotomy is performed. The dura is elevated from the cavernous sinus (CS). The anterior temporal fossa floor is drilled. Foramen rotundum and ovale are opened. The PPF is exposed and the lateral margin of inferior orbital fissure (IOF) is removed. The anterolateral triangle (ALT) is drilled and the vidian nerve (VN) is exposed. Drilling between the maxillary nerve (V2) and the VN provides access to the sphenoid sinus (SphS). The medial pterygoid plate is drilled exposing the EP. The maxillary sinus (MaxS) is opened anterior to the PPF. V2 is transposed laterally to enlarge the anteriomedial triangle (AMT). The orbital muscle of Muller is removed as well as the medial margin of the IOF, which opens the SphS. Anteriorly, the posterior ethmoid air cells are opened. Morphometric measurements evaluating the size of the ALT were done and the PS, NC, EP were explored with the endoscope. RESULTS: The ALT and AMT triangle provides a wide exposure of the PPF, ITF, PPR. In addition, those triangles represent a deep entry point to explore the PS, NC, and EP. CONCLUSION: The ALT and AMT are useful corridors to access to the SphS, MaxS, PS, NC, and EP via a transcranial approach. The use of the endoscope through this corridor widely extend the extradural anterior temporal fossa approach which may be considered as a valuable alternative to the extended endoscopic endonasal approach for selected skull base lesions extending both intracranial and into the PS, NC and EP.

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Published In

Acta Neurochir (Wien)

DOI

EISSN

0942-0940

Publication Date

August 2021

Volume

163

Issue

8

Start / End Page

2165 / 2175

Location

Austria

Related Subject Headings

  • Sphenoid Bone
  • Pterygopalatine Fossa
  • Paranasal Sinuses
  • Neurology & Neurosurgery
  • Neuroendoscopy
  • Nasal Cavity
  • Humans
  • Cadaver
  • 3209 Neurosciences
  • 3202 Clinical sciences
 

Citation

APA
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MLA
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Watanabe, K., Passeri, T., Hanakita, S., Giammattei, L., Zomorodi, A. R., Fava, A., … Froelich, S. (2021). Extradural anterior temporal fossa approach to the paranasal sinuses, nasal cavities through the anterolateral and anteromedial triangles: Combined microscopic and endoscopic strategy. Acta Neurochir (Wien), 163(8), 2165–2175. https://doi.org/10.1007/s00701-021-04850-y
Watanabe, Kentaro, Thibault Passeri, Shunya Hanakita, Lorenzo Giammattei, Ali R. Zomorodi, Arianna Fava, Rosaria Abbritti, et al. “Extradural anterior temporal fossa approach to the paranasal sinuses, nasal cavities through the anterolateral and anteromedial triangles: Combined microscopic and endoscopic strategy.Acta Neurochir (Wien) 163, no. 8 (August 2021): 2165–75. https://doi.org/10.1007/s00701-021-04850-y.
Watanabe K, Passeri T, Hanakita S, Giammattei L, Zomorodi AR, Fava A, et al. Extradural anterior temporal fossa approach to the paranasal sinuses, nasal cavities through the anterolateral and anteromedial triangles: Combined microscopic and endoscopic strategy. Acta Neurochir (Wien). 2021 Aug;163(8):2165–75.
Watanabe, Kentaro, et al. “Extradural anterior temporal fossa approach to the paranasal sinuses, nasal cavities through the anterolateral and anteromedial triangles: Combined microscopic and endoscopic strategy.Acta Neurochir (Wien), vol. 163, no. 8, Aug. 2021, pp. 2165–75. Pubmed, doi:10.1007/s00701-021-04850-y.
Watanabe K, Passeri T, Hanakita S, Giammattei L, Zomorodi AR, Fava A, Abbritti R, Labidi M, Champagne PO, Fukushima T, Froelich S. Extradural anterior temporal fossa approach to the paranasal sinuses, nasal cavities through the anterolateral and anteromedial triangles: Combined microscopic and endoscopic strategy. Acta Neurochir (Wien). 2021 Aug;163(8):2165–2175.
Journal cover image

Published In

Acta Neurochir (Wien)

DOI

EISSN

0942-0940

Publication Date

August 2021

Volume

163

Issue

8

Start / End Page

2165 / 2175

Location

Austria

Related Subject Headings

  • Sphenoid Bone
  • Pterygopalatine Fossa
  • Paranasal Sinuses
  • Neurology & Neurosurgery
  • Neuroendoscopy
  • Nasal Cavity
  • Humans
  • Cadaver
  • 3209 Neurosciences
  • 3202 Clinical sciences