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Acta Neurochirurgica
Published in: Acta Neurochirurgica 2/2021

01-02-2021 | How I Do it - Neurosurgical Anatomy

Surgical anatomy and nuances of the expanded transpterygoid approach to the pterygopalatine fossa and upper parapharyngeal space: a stepwise cadaveric dissection

Authors: Giuliano Silveira-Bertazzo, Rafael Martinez-Perez, Ricardo L. Carrau, Daniel M. Prevedello

Published in: Acta Neurochirurgica | Issue 2/2021

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Abstract

Background

Superb knowledge of anatomy and techniques to remove the natural barriers preventing full access to the most lateral aspect of the skull base determines the ease of using the transpterygoid approach (ETPA) as the main gateway for all the coronal planes during endonasal surgeries.

Methods

Throughout stepwise image-guided cadaveric dissections, we describe the surgical anatomy and nuances of the ETPA to the pterygopalatine fossa (PPF) and upper parapharyngeal space (UPPS).

Conclusion

The ETPA represents a lateral extension of the midline corridor and provides a valuable route to access the PPF/UPPS. Major landmarks for this EEA are the infraorbital canal, sphenopalatine foramen, and vidian nerve. It comprises the removal of the palatine bone, posterior wall of the maxillary sinus, and PPF transposition to drill the pterygoid process.
Literature
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Metadata
Title
Surgical anatomy and nuances of the expanded transpterygoid approach to the pterygopalatine fossa and upper parapharyngeal space: a stepwise cadaveric dissection
Authors
Giuliano Silveira-Bertazzo
Rafael Martinez-Perez
Ricardo L. Carrau
Daniel M. Prevedello
Publication date
01-02-2021
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 2/2021
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-020-04551-y

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