Relationships of the vidian nerve and internal carotid artery: MRI and intraoperative surgical evaluation.

IF 2.1 4区医学 Q2 OTORHINOLARYNGOLOGY

Acta Otorhinolaryngologica Italica Pub Date : 2024-08-01 DOI:10.14639/0392-100X-N2889

Iacopo Dallan, Marco Verstegen, Silvia Canovetti, Mario Turri-Zanoni, Christos Georgalas, Giacomo Fiacchini, Christina Cambi, Daniel Prevedello, Wouter van Furth

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引用次数: 0

Abstract

Objective: Skull base anatomy around the internal carotid artery (ICA) is extremely complex. Among anatomical landmarks studied, the vidian canal has been thoroughly evaluated, unlike the vidian nerve (VN). Our aim is to evaluate the VN-ICA relationships, and understand their role in terms of surgical planning.

Methods: Fifty MRI examinations of 100 healthy petro-spheno-clival regions were reviewed in order to evaluate the relationship between the vidian nerve axis (VNA) and the petrous ICA. Twenty-seven cases of expanded endonasal approaches to petrous apex region were evaluated to check the VN-ICA relationship intraoperatively.

Results: MRI evaluations showed that, in 23% of cases, the VNA was below the edge of the ICA, in 45% it was at the edge of the ICA and in 32% it ended up above the edge of the ICA. Surgically speaking, in 9 of 28 petrous apex approaches, the VN ended above the inferior edge of the petrous carotid.

Conclusions: MRI evaluation adds useful information in planning the surgical approach to petro-spheno-clival regions, even if the identification of VNA, in these cases, may not be radiologically possible. Surgical experience confirms the importance of VN identification in guiding the surgeon in complex cases, and also outline the possible risks of relying only on this landmark.

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维神经和颈内动脉的关系：核磁共振成像和术中手术评估。

目的：颈内动脉（ICA）周围的颅底解剖极为复杂。在所研究的解剖地标中，椎管已得到全面评估，但椎管神经（VN）则不同。我们的目的是评估 VN 与 ICA 的关系，并了解它们在手术规划方面的作用：方法：我们回顾了 100 例健康的瓣膜-鼻腔-clival 区域的 50 例 MRI 检查，以评估吠陀神经轴（VNA）与瓣膜 ICA 之间的关系。为了在术中检查维神经轴与瓣状ICA的关系，还对27例扩大的瓣状顶区鼻内入路病例进行了评估：核磁共振成像评估显示，在 23% 的病例中，VNA 低于 ICA 边缘，45% 的病例中，VNA 位于 ICA 边缘，32% 的病例中，VNA 最终高于 ICA 边缘。从手术角度看，在28例颈动脉瓣顶入路中，有9例的VN最终位于颈动脉瓣下缘上方：结论：磁共振成像评估为规划瓣膜-蝶窦区域的手术方法提供了有用的信息，即使在这些病例中无法通过放射学方法识别 VNA。手术经验证实了 VN 识别在指导外科医生处理复杂病例方面的重要性，同时也概述了仅依靠这一标志可能存在的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Otorhinolaryngologica Italica OTORHINOLARYNGOLOGY-

CiteScore

3.40

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Acta Otorhinolaryngologica Italica first appeared as “Annali di Laringologia Otologia e Faringologia” and was founded in 1901 by Giulio Masini. It is the official publication of the Italian Hospital Otology Association (A.O.O.I.) and, since 1976, also of the Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale (S.I.O.Ch.C.-F.). The journal publishes original articles (clinical trials, cohort studies, case-control studies, cross-sectional surveys, and diagnostic test assessments) of interest in the field of otorhinolaryngology as well as clinical techniques and technology (a short report of unique or original methods for surgical techniques, medical management or new devices or technology), editorials (including editorial guests – special contribution) and letters to the Editor-in-Chief. Articles concerning science investigations and well prepared systematic reviews (including meta-analyses) on themes related to basic science, clinical otorhinolaryngology and head and neck surgery have high priority.