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Lateral and Superior Perspective View after Left Petrosectomy

Surgical Correlation


Lateral and superior perspective view after left petrosectomy. Cranial nerves III (oculomotor), IV (trochlear), and VI (abducens) enter the cavernous sinus with V1 (ophthalmic nerve) and the internal carotid artery. The ophthalmic (V1), maxillary (V2), and mandibular (V3) nerves are dissected beyond the Gasserian (trigeminal) ganglion. V3 has anteriorly-projecting branches, including the buccal and lingual nerves, and also gives rise to the auriculotemporal nerve whose roots enclose the middle meningeal artery. The maxillary artery is a terminal branch of the external carotid artery and has numerous branches, including the posterior superior alveolar artery, middle meningeal artery, deep temporal arteries, and the pterygoid artery. The great auricular nerve, originating from the cervical plexus, is also present lateral to the facial nerve after the facial nerve emerges from the stylomastoid foramen (not visible). The ascending pharyngeal artery and occipital artery course superiorly initially paired before the occipital artery turns posteriorly. The oculomotor nerve exits the medial midbrain between the posterior cerebral artery (superior) and the superior cerebellar artery (inferior). (Image courtesy of AL Rhoton, Jr.)