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Endoscopic approach to the trigeminal nerve: an anatomic study.

Jia-ping Zheng1, Ming Song2, Xiang-xin Zhan2

  • 1Department of Neurosurgery, Yuquan Hospital, Tsinghua University, 5 Shijingshan Road, Shijingshan District, Beijing 100049, China.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|November 26, 2013
PubMed
Summary

Endoscopic dissection reveals key pterygopalatine fossa structures for tracing the trigeminal nerve (cranial nerve V). Anteromedial maxillectomy is crucial for accessing deeper cranial nerves and vessels.

Keywords:
EndoscopicMaxillotomyPetroclival regionPterygopalatine fossaTrigeminal

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Area of Science:

  • Neurosurgery
  • Anatomy
  • Endoscopic Surgery

Background:

  • The trigeminal nerve (cranial nerve V) is a complex cranial nerve with significant surgical importance.
  • Understanding its intricate anatomy is crucial for neurosurgeons and head and neck specialists.

Purpose of the Study:

  • To provide an endoscopic anatomical description of the trigeminal nerve.
  • To detail key landmarks within the pterygopalatine fossa for trigeminal nerve dissection.

Main Methods:

  • Endoscopic dissection of nine adult cadaveric heads.
  • Systematic identification and tracing of anatomical structures.

Main Results:

  • The pterygopalatine fossa serves as a critical entry point, allowing identification of the maxillary nerve (V2), pterygopalatine ganglion, and vidian nerve.
  • These structures can be traced to the gasserian ganglion and internal carotid artery.
  • Anteromedial maxillectomy enhances surgical access to the mandibular nerve, petrous carotid artery, and cochlea.

Conclusions:

  • Key anatomical structures within the pterygopalatine fossa are vital for identifying other segments of the trigeminal nerve.
  • Anteromedial maxillectomy is essential for exposing the ipsilateral mandibular nerve and contralateral cranial structures related to the trigeminal nerve.