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The Displacement Patterns of Petrous Internal Carotid Artery and Its Morphometric Relations with Vidian Canal in Petroclival Chondrosarcomas Relevant to Extended Endoscopic Endonasal Approaches: A Radiological Study.
- Source :
-
World neurosurgery [World Neurosurg] 2024 May; Vol. 185, pp. e1049-e1056. Date of Electronic Publication: 2024 Mar 12. - Publication Year :
- 2024
-
Abstract
- Background: Extended endoscopic endonasal approaches (EEAs) to petroclival chondrosarcomas (PCs) require a thorough understanding of skullbase anatomy, especially the anatomy of petrous internal carotid artery (pICA), as ICA injury is the most dreaded complication of extended EEAs. We conducted this study to determine the displacement patterns of pICA in patients with PCs.<br />Methods: Contrast enhanced computed tomography scan and angiography images of patients with PCs were analyzed for following parameters-antero-posterior, cranio-caudal, medio-lateral, and direct distances between anterior genu of petrous internal carotid artery (AGpICA) and posterior end of Vidian canal (pVC). pICA encasement/narrowing by tumor was noted on magnetic resonance imaging.<br />Results: We studied 11 patients with histopathologically proven PCs. pICA encasement/narrowing and pVC destruction were observed in one patient each. The mean antero-posterior and cranio-caudal distances on tumor side/normal side were 7.7 ± 1.9/6.4 ± 1.0 mm & 4.5 ± 1.5/3.4 ± 0.9 mm, respectively. The overall displacement was posterior & superior. Medio-lateral displacement was seen in 4 patients (lateral in 3 and medial in 1). In rest, AGpICA was centered on pVC. The mean direct distance was 9.4 ± 2.5 mm. In 3 patients with displacement seen in all three axes, direct distance was measured by the "cuboid method." Overall, posterior-superior-lateral, posterior-superior, and anterior-inferior were the common displacement patterns of AGpICA relative to pVC.<br />Conclusions: The displacement patterns of AGpICA in PCs are variable. An individualized approach with meticulous analysis of preoperative imaging can help in determining the relation between AGpICA and pVC. This detailed morphometric information can facilitate better orientation to altered anatomy, which can be helpful in preventing pICA injury during extended EEAs.<br /> (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Male
Female
Middle Aged
Adult
Aged
Magnetic Resonance Imaging
Tomography, X-Ray Computed
Cranial Fossa, Posterior diagnostic imaging
Cranial Fossa, Posterior surgery
Retrospective Studies
Carotid Artery, Internal diagnostic imaging
Carotid Artery, Internal surgery
Skull Base Neoplasms surgery
Skull Base Neoplasms diagnostic imaging
Petrous Bone diagnostic imaging
Petrous Bone surgery
Chondrosarcoma surgery
Chondrosarcoma diagnostic imaging
Neuroendoscopy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 185
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 38484969
- Full Text :
- https://doi.org/10.1016/j.wneu.2024.03.020