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Skull Base 2011; 21(5): 329-334
DOI: 10.1055/s-0031-1284215
ORIGINAL ARTICLE

© Thieme Medical Publishers

Petrous Carotid Exposure with Eustachian Tube Preservation: A Morphometric Elucidation

Anirban Deep Banerjee1 , [*] , Jai Deep Thakur1 , [*] , Haim Ezer1 , Prashant Chittiboina1 , Bharat Guthikonda1 , Anil Nanda1
  • 1Department of Neurosurgery, Louisiana State University Health Sciences Center-S, Shreveport, Louisiana
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Publication History

Publication Date:
31 August 2011 (online)

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ABSTRACT

Inadvertent injury to eustachian tube leading to cerebrospinal fluid rhinorrhea is a known complication associated with drilling of Glasscock's triangle to expose the horizontal petrous internal carotid artery (ICA) for management of difficult tumors (especially malignant) or aneurysms at the cranial base. Contrary to the usual approach, we hypothesize that a “medial-to-lateral” approach to Glasscock's triangle drilling will minimize eustachian tube injury. Four formalin-fixed human cadaveric heads were dissected, and underwent appropriate morphometric analysis; yielding a total of eight datasets. The diameter of the horizontal petrous ICA exposed was 4.7 ± 0.9 mm (range, 3.8 to 5.6 mm).The mean distance from the medial carotid wall midpoint to the medial-most point on the eustachian tube was 6.35 ± 0.58 mm (range, 5.4 to 7.1 mm), yielding a “safety zone” for eustachian tube, ranging 0.2 to 1.9 mm lateral to the lateral carotid wall. With the medial-to-lateral approach, the eustachian tube remained preserved in all the specimens. The results of our study provide a practical, consistent, and safe method of maximizing horizontal petrous carotid artery exposure while minimizing the eustachian tube injury.

KEYWORDS

Petrous - carotid - eustachian tube - morphometric

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1 These authors have contributed equally in this study.

Anil NandaM.D. F.A.C.S. 

Professor and Chair, Department of Neurosurgery, Louisiana State University Health Sciences Center–Shreveport

1501 Kings Highway, Shreveport, LA 71103

Email: ananda@lsuhsc.edu

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