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Related Experiment Video

Updated: Apr 28, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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[Endoscopic Anterior Transpetrosal Approach].

Satoshi Suehiro1

  • 1Department of Neurosurgery, Ehime University Graduate School of Medicine.

No Shinkei Geka. Neurological Surgery
|April 27, 2026
PubMed
Summary

Endoscopic anterior transpetrosal approach (eATPA) offers a minimally invasive alternative to microscopic techniques for petrous apex lesions. This approach enhances visualization and reduces brain retraction, improving safety and outcomes for skull base surgery.

Area of Science:

  • Neurosurgery
  • Skull Base Surgery
  • Minimally Invasive Techniques

Background:

  • Anterior transpetrosal approach (ATPA) is standard for petrous apex lesions.
  • Microscopic ATPA has limitations: restricted visibility and temporal lobe retraction risks.

Purpose of the Study:

  • Review endoscopic ATPA (eATPA) and its advantages.
  • Highlight eATPA's role in skull base surgery.

Main Methods:

  • Utilizes a panoramic endoscopic view via small craniotomy.
  • Focuses on extradural drilling of Kawase's triangle.
  • Details surgical anatomy and complication avoidance strategies.

Main Results:

  • eATPA significantly reduces brain retraction and eliminates blind spots.

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  • Effective for small petroclival meningiomas, trigeminal schwannomas, and epidermoid cysts.
  • Addresses venous congestion and CSF leakage risks.
  • Conclusions:

    • eATPA is a minimally invasive skull base technique for specific lesions.
    • It's a key component for future multicorridor strategies in complex skull base pathologies.
    • Offers safer, customized treatments when combined with other approaches.