Meckel's cave access: Anatomic study comparing the endoscopic transantral and endonasal approaches

Jason Van Rompaey, Anand Suruliraj, Ricardo Carrau, Benedict Panizza, Clementino Arturo Solares

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Recent advances in endonasal endoscopy have facilitated the surgical access to the lateral skull base including areas such as Meckel's cave. This approach has been well documented, however, few studies have outlined transantral specific access to Meckel's. A transantral approach provides a direct pathway to this region obviating the need for extensive endonasal and transsphenoidal resection. Our aim in this study is to compare the anatomical perspectives obtained in endonasal and transantral approaches. We prepared 14 cadaveric specimens with intravascular injections of colored latex. Eight cadavers underwent endoscopic endonasal transpterygoid approaches to Meckel's cave. Six additional specimens underwent an endoscopic transantral approach to the same region. Photographic evidence was obtained for review. 30 CT scans were analyzed to measure comparative distances to Meckel's cave for both approaches. The endoscopic approaches provided a direct access to the anterior and inferior portions of Meckel's cave. However, the transantral approach required shorter instrumentation, and did not require clearing of the endonasal corridor. This approach gave an anterior view of Meckel's cave making posterior dissection more difficult. A transantral approach to Meckel's cave provides access similar to the endonasal approach with minimal invasiveness. Some of the morbidity associated with extensive endonasal resection could possibly be avoided. Better understanding of the complex skull base anatomy, from different perspectives, helps to improve current endoscopic skull base surgery and to develop new alternatives, consequently, leading to improvements in safety and efficacy.

Original languageEnglish (US)
Pages (from-to)787-794
Number of pages8
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume271
Issue number4
DOIs
StatePublished - Jan 1 2014

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Skull Base
Latex
Cadaver
Endoscopy
Dissection
Anatomy
Morbidity
Safety
Injections

Keywords

  • Endoscopic endonasal
  • Meckel's cave
  • Sublabial antrostomy
  • Transmaxillary
  • Transnasal
  • Transpterygoid
  • Transsphenoidal

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Meckel's cave access : Anatomic study comparing the endoscopic transantral and endonasal approaches. / Van Rompaey, Jason; Suruliraj, Anand; Carrau, Ricardo; Panizza, Benedict; Solares, Clementino Arturo.

In: European Archives of Oto-Rhino-Laryngology, Vol. 271, No. 4, 01.01.2014, p. 787-794.

Research output: Contribution to journalArticle

Van Rompaey, Jason ; Suruliraj, Anand ; Carrau, Ricardo ; Panizza, Benedict ; Solares, Clementino Arturo. / Meckel's cave access : Anatomic study comparing the endoscopic transantral and endonasal approaches. In: European Archives of Oto-Rhino-Laryngology. 2014 ; Vol. 271, No. 4. pp. 787-794.
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