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A frontal route to middle and posterior cranial fossa: quantitative study for the lateral transorbital endoscopic approach and comparison with the subtemporal approach

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dc.contributor.authorGarcía Pérez, Daniel
dc.contributor.authorAbarca, Javier
dc.contributor.authorGonzález López, Pablo
dc.contributor.authorNieto, Juan
dc.contributor.authorLagares, Alfonso
dc.contributor.authorParedes, Igor
dc.contributor.departmentFarmacología
dc.date.accessioned2026-02-26T13:28:46Z
dc.date.available2026-02-26T13:28:46Z
dc.date.copyright© 2022 Elsevier Inc.
dc.date.issued2022-08-06
dc.description.abstractBackground Skull base lesions within the middle cranial fossa (MCF) remain challenging. Recent reports suggest that transorbital endoscopic approaches (TOEAs) might be particularly suitable to access the MCF and expose the lateral wall of the cavernous sinus and the Meckel's cave. Methods The present study was developed to compare the nuances of the subtemporal approach (STA) with those of the lateral TOEA (LTOEA) to the MCF and posterior cranial fossa (PCF) in cadaveric specimens. After orbital craniectomy, interdural opening of the cavernous sinus lateral wall (CSlw), exposure of the Gasserian ganglion, and extradural elevation of the temporal lobe was performed. Next, anterior endoscopic petrosectomy was performed and the PCF was accessed. We quantitatively analyzed and compared the angles of attack and distances between LTOEA and STA to different structures at the CSlw, petrous apex (PA), and PCF. Results Cadaveric dissection through the LTOEA completely exposed the CSlw and PA. LTOA exhibited larger distances than the STA to all targets. Importantly, these differences were greater at the PA and its surrounding key anatomic landmarks. The horizontal and vertical angles of attack allowed by the LTOA were smaller both for the CSlw and PA. However, these differences were not significant for the vertical angle of attack at the CSlw. Conclusions LTOEA provides a direct ventral route to the medial aspect of MCF, PA, and PCF. Although TOEAs are versatile approaches, the unfamiliar surgical anatomy and limited instrument maneuverability demand extensive cadaveric dissection before moving to the clinical setting.
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dc.identifier.citationWorld Neurosurgery, Volume 167, November 2022, Pages e236-e250
dc.identifier.doihttps://doi.org/10.1016/j.wneu.2022.07.129
dc.identifier.urihttp://hdl.handle.net/10201/214821
dc.languageeng
dc.publisherElsevier
dc.relationSin financiación externa a la Universidad
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S1878875022010865
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectAnatomic study
dc.subjectEndoscopic surgery
dc.subjectMinimally invasive neurosurgery
dc.subjectSubtemporal
dc.subjectTransorbital approach
dc.subject.odsNo relacionado con ningún objetivo de desarrollo sostenible
dc.titleA frontal route to middle and posterior cranial fossa: quantitative study for the lateral transorbital endoscopic approach and comparison with the subtemporal approach
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
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relation.isAuthorOfPublication.latestForDiscovery2f2500a1-1b27-4420-820c-db8c16e79afd
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