| Objective:To describes the feasibility and advantages and disadvantages of the operative approach for the treatment of tumor invade Meckel's cave and pterygoid canal, by dissecting adjacent structures of the nasal cavity-pterygopalatine fossa-pterygoid canal-Meckel's cave approach. Method:Fifteen adult cadaver heads (30 sides) were dissected and the correlated anatomic landmarks were observed, measured and analyzed in an operative route. Result:The approach was divided into 3 steps:entering the maxillary sinus, the later pterygopalatine fossa and the final Meckel's cave. Safe access to Meckel's cave could be achieved by finding sphenopalatine foramen and by tracing the vidian neurovascular bundles along the pterygoid canal and dissecting the quadrangular space (QS). The distances from the nasal columella to the apertura maxillaries, the sphenopalatine foramen, and the anterior foramen of the pterygoid canal were (44.08±2.61) mm, (64.83±2.42) mm, and (70.43±2.94) mm, respectively. The angles between the horizontal plate of the palatine bone and the link from nasal columella to apertura maxillaries, between the horizontal plate of the palatine bone and the link from nasal columella to sphenopalatine foramen were (38.10±2.46)°and (26.15±2.26)°, respectively. The diameter of sphenopalatine artery was (2.06±0.41) mm (ranging 1.91-2.21 mm), and the diameter of vidian artery was (1.10±0.33) mm (ranging 0.98-1.23 mm). The parasellar neurovascular structures were divided as follows in the transsphenoidal approach:the optic strut triangle (OST), the superior triangular area (STA), the superior quadrangular area (SQA), and the inferior quadrangular area (IQA)(in a rostral-to-caudal order). Conclusion:The endoscopic approach of transnasal-pterygopalatine fossa-pterygoid canal-Meckel's cave is a safe and direct way to access Meckel's cave, and could be employed for the treatment of tumor in Meckel's cave and pterygoid canal. |
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