Eustachian Tube as a Landmark to the Internal Carotid Artery in Endoscopic Skull Base Surgery

Abstract BACKGROUND Internal carotid artery (ICA) injury is a disaster in endoscopic skull base surgery, so protection of internal carotid artery is an essential task. We use 3-dimensional multimodal imaging (3D-MMI) and intraoperative navigation (ION) in endoscopic skull base surgery to locate ICA and decrease ICA injury. MATERIAL AND METHODS 26 patients underwent endoscopic skull base surgery (pituitary adenomas, chordomas, neurinomas and other tumors invading internal carotid artery) guided by 3D-MMI and ION techniques to locate ICA. RESULTS In all patients, the 3D-MMI and ION techniques enabled adequate visualization of vascular structures stereoscopically, especially the relationship between lesion and ICA, and suplly real-time navigation to locate ICA during endoscopic skull base surgery. No ICA injury happened and neurosurgeons removed tumors with relaxed mind. CONCLUSION 3D-MMI and ION techniques were found to be helpful to locate internal carotid artery and decrease ICA injury during endoscopic skull base surgery.

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Eustachian tube and internal carotid artery in skull base surgery: An anatomical study

The Laryngoscope ◽

10.1002/lary.24808 ◽

2014 ◽

Vol 124 (12) ◽

pp. 2655-2664 ◽

Cited By ~ 28

Author(s):

Jianfeng Liu ◽

Carlos D. Pinheiro-Neto ◽

Juan C. Fernandez-Miranda ◽

Carl H. Snyderman ◽

Paul A. Gardner ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Skull Base ◽

Eustachian Tube ◽

Internal Carotid ◽

Skull Base Surgery ◽

Anatomical Study

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69 internal carotid artery (ICA)injuryManagement of Internal Carotid Artery Injury During Transnasal Endoscopic Skull Base Surgery

Transnasal Endoscopic Skull Base and Brain Surgery ◽

10.1055/b-0039-171389 ◽

2019 ◽

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Skull Base ◽

Internal Carotid ◽

Skull Base Surgery ◽

Carotid Artery Injury ◽

Artery Injury ◽

Endoscopic Skull Base Surgery ◽

Internal Carotid Artery Injury

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Endoscopic Endonasal Repair of Internal Carotid Artery Injury during Endoscopic Endonasal Surgery

Journal of Neurological Surgery Reports ◽

10.1055/s-0037-1608635 ◽

2017 ◽

Vol 78 (04) ◽

pp. e125-e128 ◽

Cited By ~ 4

Author(s):

Irit Duek ◽

Gill Sviri ◽

Moran Amit ◽

Ziv Gil

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Skull Base ◽

Internal Carotid ◽

Skull Base Surgery ◽

Endoscopic Management ◽

Carotid Artery Injury ◽

Endoscopic Endonasal ◽

Artery Injury ◽

Endoscopic Skull Base Surgery

Background Injury to the cavernous portion of the internal carotid artery (ICA) during endoscopic skull base surgery is a well-recognized rare complication that can be associated with high rates of morbidity and mortality. Many techniques have been suggested to manage ICA injury with varying degrees of success. Objectives We provide a detailed technical description of an operative technique for endoscopic management of carotid artery injury. Methods A case of ICA injury during endoscopic skull base surgery is presented. The immediate treatment measurements include: (1) early recognition of ICA injury, (2) briefing of the team and preparations, (3) packing, (4) harvesting of temporalis muscle patch, (5) placement of the muscle patch over the defect, and (6) gentle compression for 10 minutes. Results The technique facilitates quick repair and restores normal blood flow through the damaged artery. Exsanguination or the symptoms of stroke that may occur from prolonged occlusion of the ICA are therefore prevented. Conclusion The proposed protocol is useful for the management of a potentially life-threatening ICA injury.

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