Anatomy Observation Of The Endoscopic Transnasal Approach To The Petroclival Region And Clinical Anatomy Observation Of Meckel Cave: A Cadaveric Study

Objective To investigate the relative relations among the anatomical marks of theendoscopic transnasal approach to the petroclival region. Methods Four cadaver heads fortotal of8sides were examined, insert the endoscopic to nasal cavity, simulate thetransnasal approach to the petroclival region surgery. Result Measured the distance fromipsilateral nostril to Meckle’s cave is73.1mm±2.67mm，angle is12.65±2.16°; the distancefrom contralateral nostril to Meckle’s cave is77.9mm±3.4mm, angle is18.8±0.8°; fromipsilateral nostril to the front bend of Intracavernous internal carotid artery is75.8mm±3.19mm; the distance from the front bend of Intracavernous internal carotidartery to middle line is9.1mm±1.2mm. Conclusion The petroclival region has manyanatomical marks and important structure, such as internal carotid artery, Detailed andsound knowledge of the microsurgical anatomy of this region is essential to performingprecise microneurosurgery. Objective To investigate the microsurgical anatomy of Meckel cave and adjacentstructures. Methods Four cadaver heads for total of8sides were examined. The skull wasopened and the brain was removed carefully to expose the whole skull base. The Meckelcave and trigeminus’branch were exposed. The length, width of mouth of Meckel cavewere measured, the distances between porus and near structures were also measured.Result Meckel cave like a mouth-shaped natural aperture connecting with the middlecranial fossa and the posterior cranial fossa. The average height of the mouth of Meckelcave was found to be3.08mm±1.29mm and the average width was7.64mm±1.35mm. Wefound the mouth of Meckel cave was located9.82mm±1.51mm superior and medial to theinternal auditory meatus and9.5mm±0.98mm superior and medial to the dural point ofabducens nerve and16.37mm±1.43mm medial to the arcuate eminence and5.32mm±1.33medial to the dural point the of nervus trochlear. Conclusion Detailed andsound knowledge of the microsurgical anatomy of Meckel cave is essential to performingprecise microneurosurgery in this region.