Wojciechowski Tomasz, Bisi Nicola, Szopiński Kazimierz, Marchioni Daniele
Department of Descriptive and Clinical Anatomy, The Medical University of Warsaw, 5 Chalubinskiego St., 02004 Warsaw, Poland.
Department of Otorhinolaryngology, Head and Neck Surgery, The Medical University of Warsaw, 1a Banacha St., 02097 Warsaw, Poland.
J Pers Med. 2024 May 12;14(5):516. doi: 10.3390/jpm14050516.
The suprageniculate fossa (SGF) is located between the geniculate ganglion, the middle cranial fossa (MCF) and the anterior semicircular canal (ASCC). An endoscopic transcanal approach has been recently proposed to treat the different lesions in this area. The aim of the study is to describe the anatomical pathway of this approach by measuring the dimensions of its boundaries while checking their correlation with the pneumatization of the SGF area.
This is a retrospective anatomical analysis of Cone Beam CT scans of 80 patients, for a total of 160 temporal bones analyzed. Two checkpoints were measured for the SGF route, as an internal and an external window. These are triangles between the MCF dura, the geniculate ganglion and the ASCC on parasagittal and axial planes. The pneumatization of the SGF was also assessed, classified and correlated with the measured dimensions.
The depth of the SGF was 7.5 ± 1.8 mm. The width of the external window was 7.5 ± 1.9, 5.6 ± 2.4 and 1.6 ± 1.6 mm for the posterior, middle and anterior points of measurement, respectively. The height of the internal window was 7.6 ± 1.2, 4.5 ± 1.5 and 1.7 ± 1.7 mm for the posterior, middle and anterior points of measurement, respectively. Type A pneumatization was found in 87 cases, type B in 34 and type C in 39. The degree of pneumatization directly correlated to the depth and height of the fossa.
The suprageniculate approach route is defined by the internal and external windows which should be evaluated during a pre-surgery imaging assessment. The detailed anatomy of the approach and the novel classification of the pneumatization of the SGF are here described which may be useful to plan a safer procedure with minimal complications.
膝上窝（SGF）位于膝状神经节、中颅窝（MCF）和前半规管（ASCC）之间。最近有人提出采用内镜经耳道入路治疗该区域的不同病变。本研究的目的是通过测量该入路边界的尺寸，并检查其与SGF区域气化的相关性，来描述该入路的解剖路径。
这是一项对80例患者的锥形束CT扫描进行的回顾性解剖分析，共分析了160侧颞骨。对SGF路径测量了两个检查点，作为内窗和外窗。这些是矢状旁平面和轴位平面上MCF硬脑膜、膝状神经节和ASCC之间的三角形。还对SGF的气化情况进行了评估、分类，并与测量尺寸进行了相关性分析。
SGF的深度为7.5±1.8mm。外窗宽度在测量的后、中、前点分别为7.5±1.9mm、5.6±2.4mm和1.6±1.6mm。内窗高度在测量的后、中、前点分别为7.6±1.2mm、4.5±1.5mm和1.7±1.7mm。发现A型气化87例，B型34例，C型39例。气化程度与窝的深度和高度直接相关。
膝上入路路径由内窗和外窗定义，术前影像学评估时应进行评估。本文描述了该入路的详细解剖结构以及SGF气化的新分类，这可能有助于规划更安全、并发症最少的手术。
