Abstract
Objective To investigate a novel dual-port endonasal and subtemporal endoscopic approach targeting
midline lesions with lateral extension beyond the intracavernous carotid artery anteriorly
and the Dorello canal posteriorly.
Methods Ten dual-port approaches were performed on five cadaveric heads. All specimens underwent
an endoscopic endonasal approach from the sella to middle clivus. The endonasal port
was combined with an anterior or posterior endoscopic extradural subtemporal approach.
The anterior subtemporal port was placed directly above the middle third of the zygomatic
arch, and the posterior port was placed at its posterior root. The extradural space
was explored using two-dimensional and three-dimensional endoscopes.
Results The anterior subtemporal port complemented the endonasal port with direct access
to the Meckel cave, lateral sphenoid sinus, superior orbital fissure, and lateral
and posterosuperior compartments of the cavernous sinus; the posterior subtemporal
port enhanced access to the petrous apex. Endoscopic dissection and instrument maneuverability
were feasible and performed without difficulty in both the anterior and posterior
subtemporal ports.
Conclusion The anterior and posterior subtemporal ports enhanced exposure and control of the
region lateral to the carotid artery and Dorello canal. Dual-port neuroendoscopy is
still minimally invasive yet dramatically increases surgical maneuverability while
enhancing visualization and control of anatomical structures.
Keywords
3D - dual port - subtemporal - endoscopy - endonasal
