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Role of resection of torus tubarius to maximize the endonasal exposure of the inferior petrous apex and petroclival area

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机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Ohio State Univ, Dept Otolaryngol Head & Neck Surg, James Canc Hosp, Wexner Med Ctr, Starling Loving Hall,Room B221,320 West 10th Ave, Columbus, OH 43210 USA [3]Johns Hopkins Sch Med, Dept Otolaryngol Head & Neck Surg, Baltimore, MD USA [4]Ohio State Univ, Wexner Med Ctr, James Canc Hosp, Dept Neurol Surg, Columbus, OH 43210 USA
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关键词: Eustachian tube petroclival region petrous apex torus tubarius transpterygoid

摘要:
Endoscopic access to the petrous apex and petroclival region often requires sacrificing the Eustachian tube (ET). This study aimed to compare the maximum exposure of the petrous apex and petroclival region via an endonasal corridor when sparing or resecting the ET and its torus. Six cadaveric specimens (12 sides) were dissected through an endonasal transpterygoid approach. Endonasal exposure of the petroclival region was completed using techniques that included the preservation of the ET (group 1), resection of the torus tubarius (group 2), and resection of the ET (group 3) were sequentially performed on each side. The working distances from the anterior genu of the petrous internal carotid artery (ICA) to the inferior boundaries of each corridor were measured and compared. In group 1, the medial petrous apex and petroclival sulcus could be exposed with a working distance of 4.08 +/- 0.67 mm. In group 2, the fossa of Rosenmuller, inferior petrous apex, and hypoglossal canal could be exposed, with a significantly increased working distance of 18.33 +/- 0.89 mm (P = .001). In group 3, the exposure and ICA control was superior and offered a working distance of 20.67 +/- 0.78 mm. No statistically significant difference derived from comparing groups 2 and 3 (P = .875). Resection of the torus tubarius can increase exposure of the petrous apex and petroclival region. It provides an alternative to resecting the ET, which might be beneficial for maintenance of middle ear function. ET resection, however, seems superior when ICA control is required.

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出版当年[2020]版:
大类 | 3 区 医学
小类 | 2 区 耳鼻喉科学 3 区 外科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 耳鼻喉科学 3 区 外科
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出版当年[2019]版:
Q1 OTORHINOLARYNGOLOGY Q2 SURGERY
最新[2023]版:
Q1 OTORHINOLARYNGOLOGY Q1 SURGERY Q2 SURGERY

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

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第一作者机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Ohio State Univ, Dept Otolaryngol Head & Neck Surg, James Canc Hosp, Wexner Med Ctr, Starling Loving Hall,Room B221,320 West 10th Ave, Columbus, OH 43210 USA
通讯作者:
通讯机构: [2]Ohio State Univ, Dept Otolaryngol Head & Neck Surg, James Canc Hosp, Wexner Med Ctr, Starling Loving Hall,Room B221,320 West 10th Ave, Columbus, OH 43210 USA [4]Ohio State Univ, Wexner Med Ctr, James Canc Hosp, Dept Neurol Surg, Columbus, OH 43210 USA [*1]Department of Otolaryngology – Head & Neck Surgery, The James Cancer Hospital, Wexner Medical Center, The Ohio State University, Starling Loving Hall, Room B221, 320 West 10th Avenue, Columbus, OH 43210, USA.
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