Anterior Petrosal Approach: Bone Work
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Here's a short video reviewing the bone work, related to the anterior petrosal approach. A right-sided temporal craniotomy has been completed. Here's the marking for foramen spinosum the route of the internal carotid artery, the roof over the internal auditory canal. And this circle refers to the location of semicircular canals. At this junction, would be locational the cochlea. Bone work focuses on removal of the petrous apex. As you'll see, as the bone is removed, the most medial border of bone work is very much limited by the presence of the clivus. Endochondral is used to complete the petrous apex, bony resection. Air cells may be encountered by removal of this bone, and surgical corridor from the middle fossa into the posterior fossa is created. Additional air cells are also encountered after the petrous apex is drilled away one can extend bony removal more posteriorly over the, I see usually this technique is not required. However, it is performed here to further illustrated the relationship of the bony landmarks. The absence of the soft tissues in the skull bone provides additional perspective to the viewer in regards to the important anatomical landmarks. In right angle probe can be used to locate the site of the entry into the IC. Further bone removal on roofs, VIC completely. Here's more magnified view of our landmarks foramen spinosum, internal carotid artery-cochlear, internal auditory canal and the semicircular canals. Next, I'm going to remove the bone over the semicircular canals, just to show you the anatomical relationships. Obviously this is not performed as an operative maneuver. Here, you can see the location of the semicircular canals. Thank you.
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