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Surgical Exposure of the Petrous Internal Carotid Artery: Practical Application for Skull Base Surgery
Author(s) -
Dew Leigh Anne,
Shelton Clough,
Harnsberger H. Ric,
Thompson B. Gregory
Publication year - 1997
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199707000-00026
Subject(s) - petrous bone , skull , internal carotid artery , medicine , carotid arteries , surgery , base (topology) , mathematics , mathematical analysis
When exposing the horizontal petrous carotid artery in preparation for intrapetrous carotid by‐pass, the surgeon has no definite landmarks to localize the perimeter of the cochlea. The results of this study provide a practical, consistent, and safe method to maximize carotid artery exposure while minimizing cochlear injury. We measured the carotid‐cochlea distance (mean, 4.3 mm) and the carotid‐cochlear angle (mean, 10.8°) in 33 temporal bones in which the extended middle fossa approach had been performed. We correlated this distance to the width of a Sheehy weapon knife, which can be easily measured intraoperatively. Twenty‐five temporal bones were imaged prior to surgical exposure using a new computed tomography (CT) protocol that can be used for preoperative assessment of the carotid‐cochlear anatomy. The carotid‐cochlea distance and carotid‐cochlear angle measured on CT are compared with postsurgical measurements.