The oculomotor-tentorial triangle. Part 1: microsurgical anatomy and techniques to enhance exposure

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Meybodi A. T., Gandhi S., Mascitelli J., Bozkurt B., Bot G., Preul M. C., ...More

JOURNAL OF NEUROSURGERY, vol.130, no.5, pp.1426-1434, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 130 Issue: 5
  • Publication Date: 2019
  • Doi Number: 10.3171/2018.1.jns173139
  • Journal Name: JOURNAL OF NEUROSURGERY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED)
  • Page Numbers: pp.1426-1434
  • Keywords: ambient cistern, crural cistern, orbitozygomatic approach, pontomesencephalic junction, posterior circulation revascularization, pretemporal approach, subtemporal approach, transcavernous approach, vascular disorders, anatomy, POSTERIOR CEREBRAL-ARTERY, INTERNAL CAROTID-ARTERY, SAFE ENTRY ZONES, TRANSCAVERNOUS APPROACH, PREPONTINE CISTERNS, BYPASS-SURGERY, ANEURYSMS, NERVE, MOBILIZATION, MANAGEMENT
  • Acibadem Mehmet Ali Aydinlar University Affiliated: Yes

Abstract

OBJECTIVE Access to the ventrolateral pontomesencephalic area may be required for resecting cavernous malformations, performing revascularization of the upper posterior circulation, and treating vascular lesions such as aneurysms. However, such access is challenging because of nearby eloquent structures. Commonly used corridors to this surgical area include the optico-carotid, supracarotid, and carotid-oculomotor triangles. However, the window lateral to the oculomotor nerve can also be used and has not been studied. The authors describe the anatomical window formed between the oculomotor nerve and the medial tentorial edge (the oculomotor-tentorial triangle [OTT]) to the ventrolateral pontomesencephalic area, and assess techniques to expand it.