Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio.
Am J Rhinol Allergy. 2020 Sep;34(5):671-678. doi: 10.1177/1945892420922757. Epub 2020 Apr 29.
The anterolateral triangle enclosed by the foramen rotundum and foramen ovale constitutes part of the floor of the middle cranial fossa (MCF).
To assess the feasibility of a transnasal prelacrimal approach for accessing the floor of MCF via an anterolateral triangle corridor and to determine the extent of maximal exposure while safeguarding neurovascular structures.
A transnasal prelacrimal approach was performed in 5 cadaveric specimens (10 sides). Following the identification of foramen rotundum and foramen ovale, the bony ridge between 2 was drilled to expose the MCF. The temporal lobe dura was then elevated laterally, and the distances from foramen ovale to the respective borders of the area of the MCF window were measured using a surgical navigation device.
The MCF was exposed with a 0° scope in all specimens also exposing significant landmarks including the middle meningeal artery, greater superficial petrosal nerve, superior petrous sinus, and arcuate eminence. Average distances from foramen ovale to the anterior, posterior, and lateral exposed borders were 22.86 ± 1.87 mm, 27.24 ± 0.94 mm, and 24.23 ± 1.61 mm, respectively. The average area of exposed MCF window was 554.12 ± 60.22 mm. Preservation of vidian nerve, greater palatine nerve, lateral nasal wall, and nasolacrimal duct was possible in all 10 sides.
It is feasible to access the floor of MCF via an endoscopic transnasal prelacrimal approach with seemingly low risk.
圆孔和卵圆孔之间的前外侧三角构成了颅中窝（MCF）底部的一部分。
评估经鼻前泪前入路通过前外侧三角通道进入 MCF 底部的可行性，并确定在保护神经血管结构的同时最大限度暴露的程度。
在 5 具尸体标本（10 侧）中进行了经鼻前泪前入路。在识别圆孔和卵圆孔后，在两者之间的骨嵴上钻孔以暴露 MCF。然后将颞叶硬脑膜向外侧抬起，并使用手术导航设备测量卵圆孔到 MCF 窗口区域各边界的距离。
所有标本均在 0° 镜下暴露 MCF，同时还暴露了重要的标志，包括脑膜中动脉、较大的岩浅大神经、岩上窦和弓状隆起。卵圆孔到前、后、外侧暴露边界的平均距离分别为 22.86±1.87mm、27.24±0.94mm 和 24.23±1.61mm。暴露的 MCF 窗口的平均面积为 554.12±60.22mm。在所有 10 侧中，均有可能保护翼管神经、腭大神经、鼻外侧壁和鼻泪管。
经鼻内镜前泪前入路进入 MCF 是可行的，风险似乎较低。
