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Radiological Study of the Carotid-Clival Window and Its Application in Endoscopic Endonasal Expanded Approaches

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • de San Roman-Mena, Laila Perez

Grupos

Abstract

BACKGROUND: The surgical approach to the petrous apex (PA) and petroclival junction (PCJ) remains a challenge. The carotid-clival window (CCW) represents the widest window available to approach the PCJ from a mediolateral endoscopic route. Here we define the CCW radiologically in nonpathological conditions, to establish the anatomic variability of the PCJ, relate this variability to pneumatization patterns, and evaluate some technical concerns conditioned by the CCW. METHODS: This was an analytical study of 10 multislice computed tomography scans from patients without SB pathology. Bilateral measures were taken at the roof and floor levels of the lacerum canal (LC) and its posterior projection over the PCJ (segments DE and QR). All measures were compared across different pneumatization patterns. RESULTS: The DE and QR lengths were found to be the most important measures affecting the width of the CCW. Wide variability was observed, with a mean DE length of 8.52 mm (range, 2.4-12.8 mm) at the LC floor level and a mean QR length of 9.11mm(range, 4.3-13.1mm) at the LC roof level. The presence of retrocarotid pneumatization was statistically significantly associatedwith longer DE and QR segments. No differenceswere found among other pneumatization patterns. CONCLUSIONS: The CCW varies widely among individuals. The presence of pneumatization behind the paraclival carotid represents an advantageous characteristic when planning an endoscopic approach to the PCJ.

Datos de la publicación

ISSN/ISSNe:
1878-8750, 1878-8769

WORLD NEUROSURGERY  ELSEVIER SCIENCE INC

Tipo:
Article
Páginas:
356-360
PubMed:
28526643
Factor de Impacto:
0,668 SCImago ℠
Cuartil:
Q2 SCImago ℠

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Keywords

  • Carotid-clival window; Endonasal approach; Endoscopic approach; Petroclival juntion; Petrous apex; Retrocarotid space

Campos de Estudio

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ECOPRES

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