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Management of the internal carotid artery in lateral skull base surgery: combine infratemporal fossa approaches with great saphenous vein reconstruction
18 April 2018 (online)
Various lateral skull base lesions, such as richly vascularized and malignant tumors invade the internal carotid artery (ICA) especially the petrous segment, which not only hinder the total removal of these lesion but also may result in catastrophic complications and unfavorable prognosis. Under these circumstances, the lateral skull base surgeons in a dilemma whether to excise the involved segment of the ICA which at high risk of postoperative palsy, stroke and even death because there exist no accurate preoperative evaluation means for the communication of the both side ICA at present. The infratemporal fossa approaches from Type A to Type C that reported by Ugo Fisch in 1988 had been proven to be the best corridors to exposure and management of cervical, petrous and cavernous segments of the ICA. We successfully combined the infratemporal fossa approaches with great saphenous vein reconstruction of the ICA to management a series of lateral skull base richly vascularized tumors such as paragangliomas/carotid body tumors and malignant tumors such as adenoid cyst carcinoma for the last three years, which result in satisfactory results. Herein, we plan to share our experience and hope for communicating with experts in this area.