Microsurgical anatomy around the origin of the ophthalmic artery with reference to contralateral pterional surgical approach to the carotid-ophthalmic aneurysm

1985 ◽  
Vol 76 (3-4) ◽  
pp. 82-89 ◽  
Author(s):  
S. Nishio ◽  
T. Matsushima ◽  
M. Fukui ◽  
K. Sawada ◽  
K. Kitamura
Keyword(s):  
Surgical Approach ◽  
Ophthalmic Artery ◽  
Microsurgical Anatomy

Revising the Indications of Transtemporal Surgical Approaches in the Modern Endoscopic Era of Skull Base Surgery: A Dying Art

2020 ◽  
Author(s):  
Ravi Sankar Manogaran ◽  
Raj Kumar ◽  
Arulalan Mathialagan ◽  
Anant Mehrotra ◽  
Amit Keshri ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Approach ◽  
Nerve Palsy ◽  
Tertiary Care ◽  
Surgical Approaches ◽  
Microsurgical Anatomy ◽  
Complete Excision ◽  
Lateral Skull Base ◽  
The Individual ◽  
Selection Of

Abstract Objectives The aim of the study is to emphasize and explore the possible transtemporal approaches for spectrum of complicated lateral skull base pathologies. Design Retrospective analysis of complicated lateral skull base pathologies was managed in our institute between January 2017 and December 2019. Setting The study was conducted in a tertiary care referral center. Main Outcome Measures The study focused on the selection of approach based on site and extent of the pathology, the surgical nuances for each approach, and the associated complications. Results A total of 10 different pathologies of the lateral skull base were managed by different transtemporal approaches. The most common complication encountered was facial nerve palsy (43%, n = 6). Other complications included cerebrospinal fluid (CSF) collection (15%, n = 2), cosmetic deformity (24%, n = 4), petrous internal carotid artery injury (7%, n = 1), and hypoglossal nerve palsy (7%, n = 1). The cosmetic deformity included flap necrosis (n = 2) and postoperative bony defects leading to contour defects of the scalp (n = 2). Conclusion Surgical approach should be tailored based on the individual basis, to obtain adequate exposure and complete excision. Selection of appropriate surgical approach should also be based on the training and preference of the operating surgeon. Whenever necessary, combined surgical approaches facilitating full tumor exposure are recommended so that complete tumor excision is feasible. This requires a multidisciplinary team comprising neurosurgeons, neuro-otologist, neuroanesthetist, and plastic surgeons. The surgeon must know precise microsurgical anatomy to preserve the adjacent nerves and vessels, which is necessary for better surgical outcomes.

scholarly journals Surgical Approach to the Cavernous Angioma of the Orbit, with Special Reference to the Orbital Microsurgical Anatomy

1998 ◽  
Vol 7 (10) ◽  
pp. 609-614
Author(s):  
Takeo Fukushima ◽  
Hirohito Tsuchimochi ◽  
Masaaki Yamamoto ◽  
Seiji Takao ◽  
Masamichi Tomonaga ◽  
...  
Keyword(s):  
Special Reference ◽  
Surgical Approach ◽  
Cavernous Angioma ◽  
Microsurgical Anatomy

Microsurgical Anatomy of the Central Retinal Artery

Neurosurgery ◽  
2006 ◽  
Vol 59 (4) ◽  
pp. 870-879 ◽  
Author(s):  
Satoshi Tsutsumi ◽  
Albert L. Rhoton
Keyword(s):  
Ophthalmic Artery ◽  
Lower Surface ◽  
Central Retinal Artery ◽  
Optic Canal ◽  
Common Trunk ◽  
Microsurgical Anatomy ◽  
Orbital Apex ◽  
Small Arteries ◽  
Retinal Artery ◽  
Muscular Branch

Abstract OBJECTIVE: To define the microsurgical anatomy of the central retinal artery (CRA) and to provide a guide to avoiding damage to it during surgery. METHODS: The anatomic characteristics of the CRA and small arteries distributed to the optic sheath were examined in 109 orbits. The origin, course, and site of entry of the artery into the optic sheath and the distance between the orbital apex and the site of entry into the sheath were examined. RESULTS: The CRAs originated directly from the intraorbital ophthalmic artery or in a common trunk with a posterior ciliary or a muscular branch. The CRAs most commonly originated on the inferomedial side of the ophthalmic artery an average of 8.4 mm distal to the orbital end of the optic canal. They penetrated the optic sheath near the junction of the middle and anterior thirds of the length of the intraorbital optic nerve an average of 18.6 mm distal to the optic canal. More than 70% of CRAs penetrated near the midline of the lower surface of the optic sheath, 21% entered the inferomedial surface, and 7% the inferolateral or lateral surface of the optic sheath. Only one CRA gave off a branch before penetrating the nerve. CONCLUSION: The CRA is at risk of being damaged or occluded during procedures involving a large part of the orbit. Procedures directed along the lower half of the proximal two-thirds of the optic sheath have the greatest risk of interrupting the artery.

Middle Meningeal Origin of the Ophthalmic Artery

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 401-407 ◽  
Author(s):  
Qingliang Liu ◽  
Albert L. Rhoton
Keyword(s):  
Ophthalmic Artery ◽  
Middle Meningeal Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Microsurgical Anatomy ◽  
Superior Orbital Fissure ◽  
Anatomic Dissection ◽  
Retinal Artery ◽  
Arteries And Veins ◽  
Meningeal Artery

Abstract OBJECTIVE To examine the microsurgical anatomy and clinical significance of an anomalous origin of the ophthalmic artery from the middle meningeal artery. METHODS In the course of an anatomic study of the cavernous sinus, an anomalous ophthalmic artery arising from the middle meningeal artery was found. To further define the anatomy of the region, five additional skulls, in which the arteries and veins were injected with colored latex, were dissected using 3× to 40× magnification. RESULTS The anomalous ophthalmic artery arose from the frontal branch of the middle meningeal artery, passed through the superior orbital fissure, and supplied the entire contents of the orbit, as well as giving rise to the central retinal artery. This study provides the first display of this anomaly in an anatomic dissection. CONCLUSION The ophthalmic artery may infrequently arise from the middle meningeal artery. This anomaly places the ophthalmic artery at risk during procedures in which the dura is elevated from the greater and lesser wings of the sphenoid or when the sphenoid ridge is removed and during embolization procedures involving the branches of the external carotid artery.

A microsurgical study of the anatomy and course of the ophthalmic artery and its possibly dangerous anastomoses

2007 ◽  
Vol 106 (1) ◽  
pp. 142-150 ◽  
Author(s):  
Paolo Perrini ◽  
Andrea Cardia ◽  
Kenneth Fraser ◽  
Giuseppe Lanzino
Keyword(s):  
Optic Nerve ◽  
Ophthalmic Artery ◽  
Endovascular Procedures ◽  
Middle Meningeal Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Detailed Knowledge ◽  
Microsurgical Anatomy ◽  
Retinal Artery ◽  
Meningeal Artery

Object The authors studied the microsurgical anatomy of the ophthalmic artery (OphA), paying particular attention to its possibly dangerous anastomoses with the middle meningeal artery (MMA). Methods The microsurgical anatomy of the OphA and its anastomoses with the MMA were studied in 14 vessels from seven adult cadaveric heads. The origination order of the OphA branches varies in relation to whether the artery, along its intraorbital course, crosses above or below the optic nerve (ON). The central retinal artery is the first branch to course from the OphA when it crosses over the ON, and it is the second branch to course from the OphA when the artery crosses under the ON. Anastomoses between branches of the MMA and the OphA were present in the majority of the specimens examined. Conclusions Detailed knowledge of the microanatomy of the OphA and recognition of anastomoses between the external carotid artery and the OphA are critically important in avoiding disastrous complications during endovascular procedures.

scholarly journals Presurgical Simulation With Advanced 3-Dimensional Multifusion Volumetric Imaging in Patients With Skull Base Tumors

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons188-ons199 ◽  
Author(s):  
Makoto Oishi ◽  
Masafumi Fukuda ◽  
Go Ishida ◽  
Akihiko Saito ◽  
Tetsuya Hiraishi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Skull Base ◽  
Surgical Approach ◽  
Microsurgical Anatomy ◽  
Skull Base Tumors ◽  
Volumetric Imaging ◽  
3 Dimensional ◽  
Acoustic Neurinomas

Abstract BACKGROUND: Despite recent diagnostic and technical advancements in the field of neurosurgery, surgical treatment for tumors in the skull base region, ie, skull base tumors (SBTs), remains a challenge. OBJECTIVE: To validate the utility of presurgical simulation for the treatment of SBTs by 3-dimensional multifusion volumetric imaging (3D MFVI), including volume rendering and image fusion, to combine data from various imaging modalities. METHODS: We performed presurgical simulation using 3D MFVI for 21 SBTs (acoustic neurinomas, jugular neurinomas, meningiomas, chordomas, and others) in 20 patients. We collected targeted data from computed tomography, magnetic resonance imaging, computed tomography or magnetic resonance angiography, and digital subtraction angiography and combined these data using image-analyzing software. The simulations were used to assess the 3D relationships among the microsurgical anatomical components, the appropriate surgical approach, and the resectable parts of the tumor. Finally, we compared the results of the simulation with the operative results. RESULTS: In all patients, the 3D MFVI techniques enabled adequate visualization of the microsurgical anatomy and facilitated presurgical simulation, thereby allowing the surgeons to determine an appropriate and feasible surgical approach. All procedures to open the bone window were performed in accordance with the simulations, except for the surgical exposure of the acoustic canal for 2 acoustic neurinomas. In 3 of the 21 cases, tumor removal could not be performed according to the simulations because of unexpected bleeding or other restrictions. CONCLUSION: The 3D MFVI technique was of a sufficiently high quality to enable visualization of the 3D microsurgical anatomy. This promising method can facilitate determination of the most appropriate approach and safe and precise surgical procedures for SBTs.

Surgery of Carotid Cave Aneurysm with Special Reference to Microsurgical Anatomy of the Ophthalmic Artery

2015 ◽  
pp. 666-669
Author(s):  
Shigeaki Kobayashi ◽  
Masanobu Hokama ◽  
Toshihide Toriyama ◽  
Yuichiro Tanaka ◽  
Hiroshi Okudera
Keyword(s):  
Special Reference ◽  
Ophthalmic Artery ◽  
Microsurgical Anatomy

Impact of anomalous origin of the ophthalmic artery from the middle meningeal artery on selection of surgical approach to skull base meningioma

2007 ◽  
Vol 68 (5) ◽  
pp. 568-571 ◽  
Author(s):  
Nakamasa Hayashi ◽  
Michiya Kubo ◽  
Yoshifumi Tsuboi ◽  
Shinjitu Nishimura ◽  
Michiharu Nishijima ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Approach ◽  
Ophthalmic Artery ◽  
Middle Meningeal Artery ◽  
Anomalous Origin ◽  
Skull Base Meningioma ◽  
Meningeal Artery ◽  
Selection Of

scholarly journals Microsurgical Anatomy of the Lateral Ventricle and Surgical Approaches(Surgical Approach for Ventricular and Brain Stem Lesion)

2011 ◽  
Vol 20 (6) ◽  
pp. 418-423 ◽  
Author(s):  
Hidehiro Oka ◽  
Masatou Kawashima ◽  
Satoru Shimizu ◽  
Satoshi Utsuki ◽  
Shigeyuki Osawa ◽  
...  
Keyword(s):  
Brain Stem ◽  
Surgical Approach ◽  
Lateral Ventricle ◽  
Surgical Approaches ◽  
Microsurgical Anatomy ◽  
Special Issue ◽  
Brain Stem Lesion ◽  
Stem Lesion
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