AbstractOBJECTIVE:To describe and anatomically analyze the amount of exposure provided by an anterior subtemporal, medial transpetrosal approach to access the upper third of the basilar artery, ventral mesencephalon, pons, and posterior cavernous sinus.PATIENTS AND METHODS:The outcomes of six patients who underwent surgical treatment via the anterior subtemporal, medial transpetrosal approach at our institution during the past 2 years were reviewed. The series included three patients with subarachnoid hemorrhage from low-lying basilar apex aneurysms, one patient with intraparenchymal hemorrhage from a pontine cavernous malformation, and two patients with slowly progressive cranial neuropathies secondary to petroclival tumors. Thirty dry temporal bone specimens were also measured to quantify the height of petrous bone resection and added proximal basilar artery exposure.RESULTS:The surgical exposure was greatly enhanced in each instance, allowing each lesion to be treated in a straightforward manner with minimal added morbidity (one trochlear nerve palsy, one worsening of a preexistent oculomotor nerve palsy). Our subsequent morphometric analysis indicates that an additional 1 to 1.5 cm of basilar artery, clivus, and pons exposure over that of a standard anterior subtemporal approach is provided by this technique.CONCLUSION:This approach combines the wide view of the suhtemporal approach with the more proximal exposure afforded by a medial petrosectomy. The widened visualization of the ventral pons and mesencephalon minimizes cranial nerve morbidity, greatly facilitates dissection of low-lying aneurysms, and provides proximal basilar artery control that would otherwise be obscured by the petrous ridge.
Neurosurgery – Oxford University Press
Published: Jul 1, 1998
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.
All for just $49/month
Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.
Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.
It’s easy to organize your research with our built-in tools.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera