Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT, 84132, USA.
Acta Neurochir (Wien). 2024 Feb 26;166(1):107. doi: 10.1007/s00701-024-05996-1.
The foramen rotundum and anterior cavernous sinus have traditionally been accessed by transcranial approaches that are limited by the high density of critical neurovascular structures. The transmaxillary approach provides an entirely extradural route to the foramen rotundum and anterior cavernous sinus.
This patient with neurofibromatosis and facial pain with trigeminal schwannoma at the foramen rotundum was successfully treated by transmaxillary resection of the tumor. This approach allowed for a direct extradural access to the pathology, with bony decompression and tumor resection, avoiding transcranial routes.
The transmaxillary approach provides a safe and entirely extradural corridor to access smaller localized skull base lesions at and surrounding the cavernous sinus.
圆孔和前颅窝底海绵窦传统上通过经颅入路来进入，而这些入路受到高密度的关键神经血管结构的限制。经上颌窦入路为圆孔和前颅窝底海绵窦提供了完全的硬膜外入路。
本病例为神经纤维瘤病患者，圆孔处有面部疼痛和三叉神经鞘瘤，经上颌窦肿瘤切除术成功治疗。该方法允许直接进行硬膜外入路到达病变部位，进行骨减压和肿瘤切除，避免经颅入路。
经上颌窦入路为较小的局限于颅底海绵窦及其周围的病变提供了安全的、完全的硬膜外通道。
