Microanatomy related to microsurgery through subtemporal keyhole approach

Objective To provide an anatomy base for the microsurgery through subtemporal keyhole approach.Methods Sixs pecimen of formalin-fixed cadaveric heads were dissected by simulating the microsurgery through subtemporal keyhole approach.Then eurovascular structures related to the microsurgery through the subtemporal keyhole approach were observed and the distance amongt hem were measured.The extent of exposure of the structures related to this approach was described.Results The shortest distances fromt he zygomatic arch to the tentorial edge,brain stem and anterior clinoid process were(41.1±5.1)mm,(45.6±3.3)mm and(61.1±7.4)mmr espectively.The area(279.7±45.4)mm 2 was significantly bigger after the expansive effacement of the petrous bone than that(235.7±37.7)m m2 before the expansive effacement of the petrous bone(P0.05).The nerves,vessels and the triangle which were in lateral wall of thec avernous sinus was clearly exposed by the microsurgery through subtemporal keyhole approach,by which,internal carotid artery,p osterior communicating artery and their branches,anterior choroidal artery and hypophysial stalk lateral to the saddle area were exposeda lso.The brain stem in the petroclival region was exposed better after the effacement of the apex of the temporal bone compared to thatb efore the effacement of it.Conclusions The nerves,vessels and the other structures lateral to cavernous sinus and saddle area,may bee xposed well by microsurgery through subtemporal keyhole approach,which produces only relatively little damage to the cerebral tissues.