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Bony Dehiscence of the Horizontal Petrous Internal Carotid Artery Canal: An Anatomic Study with Surgical Implications

Alexander Spiessberger1, Fabian Baumann2, Karl Friedrich Kothbauer2

  • 1Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.

World Neurosurgery
|April 4, 2018
PubMed

Insights

The horizontal petrous carotid canal, a potential alternative donor site for bypass surgery, showed bony roof dehiscence in 25% of cadavers. This anatomical variation may simplify surgical access for high-flow bypass procedures.

Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Anatomy

Background:

  • The cervical carotid artery is the standard donor site for high-flow bypass.
  • The horizontal petrous internal carotid artery (ICA) offers potential advantages including shorter graft length and intracranial protection.

Purpose of the Study:

  • To investigate the morphometric variations of the petrous carotid canal.
  • To determine the incidence of bony dehiscence in the roof of the horizontal petrous carotid canal.
  • To assess the potential of petrous carotid canal anatomy for improving high-flow bypass procedures.

Main Methods:

  • A morphometric analysis was performed on 4 human cadaver heads.
  • A subtemporal approach was used to expose the horizontal petrous ICA.
  • Measurements of the vessel segment and surrounding bony anatomy were recorded.

Main Results:

  • The mean long axis of the horizontal petrous ICA was 9.6 mm.
  • The mean diameter of the horizontal petrous ICA was 4.9 mm.
  • Bony dehiscence of the canal roof was observed in 25% of the investigated specimens.

Conclusions:

  • A dehiscent bony roof of the horizontal petrous carotid canal can facilitate vessel exposure for high-flow bypass.
  • The presence of dehiscence was noted in 25% of specimens.
  • Preoperative imaging can identify this feature, aiding patient selection for bypass procedures.
Abstract

Keywords:
Complex aneurysmsHigh-flow bypassPetrous ICA

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