J Neurol Surg B Skull Base 2012; 73(04): 261-264
DOI: 10.1055/s-0032-1312717
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Path to the Interpeduncular Fossa: Anatomical Comparison of Endoscopic-Assisted versus Standard Subtemporal Approach

Tariq Lamki
1   Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
,
Asem Salma
1   Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
,
Nishanta Baidya
1   Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
,
Mario Ammirati
1   Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
› Author Affiliations
Further Information

Publication History

07 October 2011

16 December 2011

Publication Date:
17 May 2012 (online)

Abstract

Objective The aim of this study was to assess the assumed advantage of endoscopic assistance to the standard subtemporal approach. The idea was to measure qualitatively and quantitatively visibility versus operability.

Design We performed eight subtemporal dissections on four cadaver heads. Our dissections integrated an operating microscope, endoscope, and neuronavigation. Comparison was made between visibility and operability afforded by the microscope alone or by the microscope–endoscope combination. Visibility was recorded as complete or incomplete and was quantified for key structures using linear measurements taken by the navigation system. Operability was determined by whichever maneuvers could be safely and comfortably accomplished in the space afforded.

Results From our survey, the structures whose visibility most benefitted from the addition of the endoscope include: contralateral third nerve, posterior perforated substance, mammillary bodies, and contralateral superior cerebellar artery. With regard to quantitative evaluation, we found increased visibility of both basilar artery and posterior cerebral artery. With regard to the operability, no objective advantage was afforded by the addition of the endoscope. Subjectively, the maneuvers were easier to perform while using the endoscope.

Conclusion Using the endoscope as an assistance tool during conducting classical subtemporal approach can help in overcome a lot of the classical subtemporal approach limitations.

 
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