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J Neurol Surg B Skull Base 2014; 75(03): 147-151
DOI: 10.1055/s-0033-1356491
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Volumetry and Analysis of Anatomical Variants of the Anterior Portion of the Petrous Apex Outlined by the Kawase Triangle Using Computed Tomography

Juliano Adams Pérez
1   Department of Neurosurgery, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
,
Gustavo Rassier Isolan
1   Department of Neurosurgery, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
,
Paulo Henrique Pires de Aguiar
1   Department of Neurosurgery, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
,
Apio Martins Antunes
1   Department of Neurosurgery, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
› Author Affiliations
Further Information

Publication History

06 January 2013

15 July 2013

Publication Date:
12 March 2014 (online)

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Abstract

Background Anterior petrosectomy has become an increasingly used approach for petroclival lesions. This study measures the volume and the anatomical variants of the anterior portion of the petrous apex outlined by the Kawase triangle using computed tomography (CT).

Methods This was a transversal retrospective study. We assessed the anterior petrous apex portion outlined by the Kawase triangle in consecutive patients > 18 years of age from CT scans of temporal bone stored in an archive system. The volumetry was performed on a workstation.

Results A total of 154 petrosal apex were analyzed in 77 patients (36 men). The average volume of the region outlined by the Kawase triangle was 1.89 ± 0.52 cm3. The volume average in men was 2.01 ± 0.58 cm3, and the average in women was 1.79 ± 0.41 cm3. Intra- and interobserver agreement were both excellent, and there was little variance. Nineteen petrous apex demonstrated anatomical variations. In 18 cases it was pneumatized, and in one case a vascular or nerve-like structure was identified, a report we did not find in the literature.

Conclusion The volumetry of the petrous apex anterior portion outlined by the Kawase triangle can be made by CT with excellent intra- and interobserver agreement and reproducibility. There are anatomical variants in this region that are relevant to surgery.

Keywords

petrous apex - volumetry - Kawase triangle - surgical approach
 

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