Abstract
ObjectiveTo study anatomical structures related to Meckel cave with endonasal endoscopic approach and to provide an anatomical basis for endoscopic surgery in Meckel cave.MethodsMeckel cave of 5 adult skulls (10 sides) were fixed with 10% formalin. The anatomical structures of Meckel cave and the related zones adjacent to Meckel cave were observed and measured with endoscopic endonasal approach.ResultsEndoscopic endonasal, endo-maxillary sinus, and endo-pterygoid process approaches were successfully applied in observation of the anatomical structures of meckel cave and the rerated zones adjacent to Meckel cave and in measurement of distances between related anatomical structures for each case of samples. The relevant data were obtained. The distance between the front mouth of palatovaginal canal and vidian canal was 21.4±7 mm, the distance between opening of sphenoid sinus to the upper margin of the choana was 22.3±2.8 mm, the distance between the opening of vidian and foramen rotundum was 7.57±0.7 mm and the length of the pterygoid canal was 13.3±1.2 mm. Based on these data, the positions of the related important structures can be roughly located during surgical operation and various important structures in Meckel cave and its adjacent zones can be found out in a convenient and safe way.Conclusion1) It is feasible to use endonasal endoscopic approach to perform surgical operation in Meckel cave; 2) Use of endonasal endoscopic approach can protect and fully take the advantage of the vidian nerve to locate the position of foramina lacerum of the internal carotid artery during surgical operation; and 3) the observational and experimental data obtained with this approach can provide the rational basis for clinical operation procedures.
Highlights
Since the anatomical concept ‘Meckel’ was firstly proposed by Meckel in 1832 [1], Meckel cave, a space beneath the dura matters-containing trigeminal ganglion, has been one of the most difficult anatomical regions to deal with for a long time due to its anatomical uniqueness, such as its deep position and meticulous structures, which are surrounded by other adjacent complex structures and as well as other reasons
We performed an anatomical analysis on Meckel cave of fresh human skulls perfused with red latex using endoscopic endonasal, endo-maxillary sinus, and endo-pterygoid process approach to investigate the anatomical characteristics of Meckel cave and the feasibility of using these approaches to study Meckel cave, aiming to provide anatomical basis for the application of endoscopic endonasal approach for the surgical treatment of the space-occupying lesions in Meckel cave
Applications of endoscopic endonasal, endo-maxillary sinus, endo-pterygoid process approaches were found to be feasible for performing surgery in Meckel sac and these approaches were found to be capable of reaching and dealing with Meckel sac
Summary
Since the anatomical concept ‘Meckel’ was firstly proposed by Meckel in 1832 [1], Meckel cave ( called Meckle cavity), a space beneath the dura matters-containing trigeminal ganglion, has been one of the most difficult anatomical regions to deal with for a long time due to its anatomical uniqueness, such as its deep position and meticulous structures, which are surrounded by other adjacent complex structures and as well as other reasons. It has been one of the technical difficulties to treat the spaceoccupying lesion located in this region. We performed an anatomical analysis on Meckel cave of fresh human skulls perfused with red latex using endoscopic endonasal, endo-maxillary sinus, and endo-pterygoid process approach to investigate the anatomical characteristics of Meckel cave and the feasibility of using these approaches to study Meckel cave, aiming to provide anatomical basis for the application of endoscopic endonasal approach for the surgical treatment of the space-occupying lesions in Meckel cave
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