Komatsu F, Komatsu M, Di Ieva A, Tschabitscher M
Center for Anatomy and Cell Biology, Department of Systematic Anatomy, Medical University of Vienna, Vienna, Austria.
Minim Invasive Neurosurg. 2011 Oct;54(5-6):223-7. doi: 10.1055/s-0031-1287831. Epub 2012 Jan 25.
Persistent trigeminal artery (PTA) is one of the carotid-basilar anastomoses and occasionally complicates vascular or neoplastic pathology. The aim of this study was to become more familiar with the anatomy associated with PTA using an endoscopic view.
PTA was incidentally encountered in a fresh cadaver. Purely endoscopic approaches via supraorbital (extradural and intradural routes), endonasal, and retrosigmoid routes were performed with 4-mm, 0- and 30-degree rigid endoscopes.
The PTA belonged to Salas's lateral type and Saltzman's type 1. The supraorbital extradural approach allowed good visualization of the origin and the cavernous portion of the PTA through the infratrochlear triangle. Using the endonasal route, the cisternal portion of the PTA and its confluence to the basilar artery were demonstrated after opening the clival dura; however, the origin of the PTA and the cavernous portion of the PTA were not sufficiently exposed even using a direct approach to the cavernous sinus. The retrosigmoid approach revealed the anatomical relationship among the PTA, trigeminal nerve, and abducent nerve in the petroclival region.
These 3 endoscopic approaches provided a superb image of the PTA and contribute to the anatomical comprehension of PTA. Additionally, these approaches make us more familiar with an endoscopic view of PTA.
持续性三叉动脉（PTA）是颈基底吻合支之一，偶尔会并发血管或肿瘤性病变。本研究的目的是通过内镜视角更熟悉与PTA相关的解剖结构。
在一具新鲜尸体上偶然发现了PTA。使用4毫米、0度和30度硬性内镜，分别通过眶上（硬膜外和硬膜内途径）、鼻内和乙状窦后途径进行了单纯内镜手术。
该PTA属于萨拉斯外侧型和萨尔茨曼1型。眶上硬膜外入路可通过滑车下三角很好地观察到PTA的起源和海绵窦段。采用鼻内入路，打开斜坡硬膜后可显示PTA的脑池段及其与基底动脉的汇合处；然而，即使采用直接进入海绵窦的方法，PTA的起源和海绵窦段也未得到充分暴露。乙状窦后入路揭示了PTA、三叉神经和展神经在岩斜区的解剖关系。
这三种内镜入路提供了PTA的极佳图像，有助于对PTA的解剖理解。此外，这些入路使我们更熟悉PTA的内镜视角。
