Applied Anatomy Of Petroclival Region Via Subtemporal Keyhole Approach Aided With Endoscope

Objective To study the applied anatomy of the petroclival region via the subtemproal keyhole approach aided with endoscope and to explore the anatomical exposure.Method Anatomic features were studied and measured in 12 sides of 6 adult cadavers head fixed in 10% formalin and subtemporal keyhole approach was performed. Subtemporal keyhole approach was simulate in 8 sides of 4 fresh adult cadavers head whose arteries had been injected with colored silicone using microscope and neuro-endoscope, the marking structures and their relatives, the exposure scope, the working area were recorded and several techniques were applied to wide the working area.Results The neurovascular structures of upper and middle petroclival , interpeduncular cistern and prepontine cistern can be well exposed via this approach . Resection of the petrous apex can properly enlarge the anatomical of upper and middle petroclival. The area of the Day diamond-shaped section are 235.5± 15.8mm , scope are 213.5~249.7mm2. After polishing of the petrous apex, the area are 302.0±33.0mm2, scope are 264.8~348.0mm2.Conclusion The subtemporal keyhole approach has bee proven to provide sufficient operating space, obtain satisfactory outcomes for the lesions and diminish the cerebral injury by the operation in the region of upper and middle petrocival, interpeduncular cistern and prepontine cistern.