Landmarks for endoscopic approach to the parapharyngeal internal carotid artery: A radiographic and cadaveric study

Brian Ho, David W. Jang, Jason Van Rompaey, Ramon Figueroa, Jimmy J. Brown, Ricardo L. Carrau, C. Arturo Solares

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Objectives/Hypothesis To define transnasal endoscopic surgical landmarks for the parapharyngeal segment of the internal carotid artery (ppICA) using radiographic analysis and cadaveric dissection. Study Design Cadaveric and radiographic study. Methods One hundred seventy-nine computed tomography angiography studies of the head and neck were analyzed using Osirix third-party software (Pixmeo, Geneva, Switzerland). Dissection of a cadaveric specimen was used as a correlate to radiographic findings. The posterior aspect of the lateral pterygoid process and posterior border of the mandibular ramus were used as bony landmarks for the ppICA. Results At the level of the nasal floor, the distance from the ppICA to the posterolateral pterygoid process and to the posterior mandibular ramus was 2.36 cm and 1.94 cm, respectively, in males, and 2.37 cm and 1.99 cm, respectively, in females. At the level of the skull base, the distance from the ppICA to the posterolateral pterygoid process and to the posterior mandible was 2.33 cm and 1.49 cm, respectively, in males, and 2.20 cm and 1.57 cm, respectively, in females. Cadaver dissection demonstrated the utility of identifying these landmarks. Conclusions The posterior border of the mandibular ramus and the posterolateral aspect of the pterygoid process may serve as consistent bony landmarks for identification of the ppICA. Level of Evidence NA

Original languageEnglish (US)
Pages (from-to)1995-2001
Number of pages7
JournalLaryngoscope
Volume124
Issue number9
DOIs
StatePublished - Sep 2014

Keywords

  • Parapharyngeal internal carotid artery
  • endoscopic skull base surgery
  • three-dimensional anatomic rendering
  • three-dimensional volume rendering

ASJC Scopus subject areas

  • Otorhinolaryngology

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