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Endoscopic endonasal approach to the vidian nerve and its relation to the surrounding structures: an anatomic cadaver study

  • Rhinology
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Abstract

Purpose

The aim of this study was to investigate the neurovascular structures and their relevant anatomy with the endonasal endoscopic transpterygoid approach on fresh human cadavers. In addition, the relationship between the vidian nerve, ICA and surrounding structures were investigated

Methods

This study was carried out at an otolaryngology department of a tertiary medical center between June 2014 and June 2015. Ten fresh human cadavers were included in this study. Pterygopalatine fossa was explored via an endoscopic endonasal transpterygoid approach. Same surgical dissection procedures were performed on all cadavers: maxillary antrostomy, anterior and posterior ethmoidectomy, sphenoidotomy, transpterygoid pterygopalatine fossa and vidian canal dissection.

Results

Mean distance between the anterior nasal spine and ethmoidal crest was 60.35 ± 1.31 mm (range 59–64 mm). Mean distance between the sphenopalatine foramen and superior border of choana was 18.30 ± 1.38 mm (range 17–22 mm). Mean distance between the vidian canal and sphenopalatine foramen was 6.30 ± 0.47 mm (range 5.5–7 mm). Mean distance between the vidian canal and anterior nasal spine was 64.6 ± 1.71 mm (range 62–67 mm). Foramen rotundum was located superior lateral to the vidian canal in all specimens. Mean distance between foramen rotundum and vidian canal was 9.45 ± 0.60 mm (range 8.5–10.5 mm). Course of the greater palatine nerve was always medial to the descending palatine artery. The mean length of the vidian nerve from the petrous ICA to the point the nerve exits the vidian canal (vidian canal length) was 17.90 ± 1.59 mm (range 16–20 mm).

Conclusions

The distances between the vidian canal and surrounding neurovascular structures would help the skull base surgeon in this narrow and complex area.

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Acknowledgements

Special thanks to Merve Evren fort the medical illustrations.

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Authors and Affiliations

  1. Otolaryngology Department, Ege University School of Medicine, 35100, Izmir, Turkey

    Bulent Karci, Rasit Midilli, Umut Erdogan, Goksel Turhal & Sercan Gode

Authors
  1. Bulent Karci
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  2. Rasit Midilli
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  3. Umut Erdogan
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  4. Goksel Turhal
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  5. Sercan Gode
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Corresponding author

Correspondence to Goksel Turhal.

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Informed consent

Not required because the study was conducted on cadavers.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

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Karci, B., Midilli, R., Erdogan, U. et al. Endoscopic endonasal approach to the vidian nerve and its relation to the surrounding structures: an anatomic cadaver study. Eur Arch Otorhinolaryngol 275, 2473–2479 (2018). https://doi.org/10.1007/s00405-018-5085-2

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  • DOI: https://doi.org/10.1007/s00405-018-5085-2

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