Endoscopic and Microsurgical Anatomy of the Cranial Base

This atlas illustrates the anatomical structures of the internal and external cranial base and their topography essential to transnasal endoscopic surgical approaches. Currently, the majority of transnasal microsurgical interventions are largely restricted to hypophyseal interventions. The petrous part of the temporal bone and the retrosellar median area have only been cautiously approached using microsurgical endoscopy due to a current lack of technical experience and topographical knowledge. These approaches are common in the US, though, where they are already successfully conducted which calls for a profound anatomical knowledge. Thus the author focuses on the cranial base and the different approaches in order to prepare surgeons for these interventions. Several anatomical variants and special surgical aspects are presented. The excellent drawings base upon anatomical preparations, cadaver dissections and intra-OP demonstrations collected in the course of the author's decades of neurosurgical experience. ISBN-13: 978-3211993194 Endoscopic and Microsurgical Anatomy of the Cranial Base 1 Front-matter 2 Title Page 3 Copyright Page 4 Preface 5 Table of Contents 6 CHAPTER I SURVEY (Figs. 1 to 8) 8 Overview (Figs. 1 to 5) 9 Topography of the endoscopic routes (Figs. 6 to 8) 9 Cavum nasi and paranasal sinuses 9 Foramen sphenopalatinum and adjacent structures 9 Foramen lacerum 9 Pyramis (petrous bone) 9 Literature 26 CHAPTER II CAVUM NASI AND FOSSA PTERYGOPALATINA (Figs. 9 to 17) 27 Overview (Figs. 9 and 10) 28 Cavum nasi (Fig. 10) 28 Hiatus maxillaris (Fig. 11) 28 Other paranasal sinuses (Fig. 12) 28 Foramen sphenopalatinum and Fossa pterygopalatina (Figs. 13 to 19) 29 Foramen sphenopalatinum 29 Fossa pterygopalatina 29 Vessels and nerves of the area of Foramen sphenopalatinum 29 A. maxillaris 29 Veins: Plexus pterygoideus 29 Nerves: 29 Literature 48 CHAPTER III SINUS SPHENOIDALIS AND FOSSA PTERYGOPALATINA (Figs. 18 to 34) 49 Overview (Figs. 18 to 20) 50 Sinus sphenoidalis (Figs. 19 and 20) 50 Widening of adjacent structures (Figs. 27, 28, and 33). 50 Area between Sinus sphenoidalis and Foramen lacerum (Figs. 19 to 34) 50 Anterior wall of Sinus sphenoidalis 50 Foramen sphenopalatinum (Figs. 23 to 25) 50 Fossa pterygopalatina (Figs. 22 to 26, and 28 to 33) 50 Foramen lacerum and its contents (Figs. 23 to 31) 51 Literature 86 CHAPTER IV TUBA AUDITIVA (EUSTACHII) (Figs. 35 to 40) 87 Overview (Figs. 35 und 36) 88 Pars cartilaginea 88 Pars ossea (C in Fig. 37, and Fig. 40) 88 Literature 101 CHAPTER V PYRAMIS (PETROUS BONE, PARS PETROSA PLUS PARS TYMPANICA) (Figs. 41 to 63) 102 Overview (Figs. 41 to 43) 103 Pyramis, schematic drawing (Figs. 42 and 43) 103 Facies posterior pyramidis (Fig. 42) 103 Facies anterior pyramidis (Fig. 43) 103 Facies inferior pyramidis (Fig. 43) 103 Course of Canalis caroticus (Figs. 42 and 43) 103 Dorsal and basal axis of Pyramis (Figs. 44, 45, 47 and 48) 104 Cadaver skull dissections (Figs. 45 to 63) 104 Apex pyramidis, Facies posterior, anterior and inferior (Fig. 45) 104 Facies posterior pyramidis (Fig. 46) 104 Facies anterior pyramidis (Fig. 47) 104 Facies inferior pyramidis (Figs. 48 to 50) 104 Variants of Pyramis (Figs. 53 to 56) 104 Structures adjacent to Labyrinth (Figs. 60 to 63) 105 Relationship of Canalis caroticus to the labyrinth bloc 105 Anterior area of the Labyrinth bloc (Fig. 60) 105 Area of Labyrinth, Apertura ext. can. carotici and of Fossa jugularis (Figs. 60 to 63) 105 Literature 152 CHAPTER VI CLIVUS AREA AND PARS CONDYLARIS (Figs. 64 to 70) 153 Overview (Figs. 64 and 65) 154 Components of the Clivus area 154 Phylogenetic, ontogenetic and dysontogenetic aspects (Fig. 66) 154 Basal extracranial Clivus area (Figs. 66 to 68) 154 Dorsal intracranial Clivus area (= Clivus Blumenbachii plus condylar part) (Figs. 4, 5, and 65) 155 Literature 170 CHAPTER VII SPECIAL SURGICAL ASPECTS. EXAMPLES (Figs. 71 to 79) 171 Planning strategies (Figs. 71 to 77) 172 Imaging techniques (Figs. 71 to 74) 172 Measurements (Figs. 75 to 77) 172 Dural penetration point of N. abducens (Figs. 76 and 77) 172 Transnasal routes (Figs. 78 and 79) 172 Literature 191 Subject Index 192 Using detailed drawings collected during the author's decades of neurosurgical experience, this atlas illustrates the anatomical structures and topography of the internal and external cranial base essential to transnasal endoscopic surgical approaches.