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. 2009 Nov 26;25(6):376–382. doi: 10.1007/s12264-009-0605-0

Nasal cavity-maxillary sinus-pterygopalatine fossa-Meckel’s cave: a preliminary anatomic study of an endoscopy-based operative approach

模拟内镜下经৳-翼腭窝至Meckel 腔入路的应用解剖学研究

Zhi-Qiang Bai 1, En-Yuan Cai 1,✉, Shi-Qiang Wang 1, Zhao-Jian Li 1, Shou-Biao Wang 2
PMCID: PMC5552503  PMID: 19927174

Abstract

Objective

To provide a new approach for the treatment of tumor in Meckel’s cave, by dissecting adjacent structures of the nasal cavity-maxillary sinus-pterygopalatine fossa-Meckel’s cave approach.

Methods

Fifteen adult cadaver heads (30 sides) were dissected and the correlated anatomic landmarks were observed, measured and analyzed in an operative route.

Results

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 tracing the vidian neurovascular bundles 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.

Conclusion

The endoscopic approach of transnasal maxillary sinus-pterygopalatine fossa-Meckel’s cave (ENMPA) is a safe and direct way to access Meckel’s cave, and could be employed for the treatment of tumor in Meckel’s cave.

Keywords: endoscope, maxillary sinus, Meckel’s cave, neuroanatomy

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