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Preauricular Subtemporal-Infratemporal Fossa Approach

Surgical Correlation

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E, A frontotemporal craniotomy has been completed and the dura of the lateral wall of the cavernous sinus has been elevated. In addition, the lateral orbital wall has been removed to expose the globe, extraocular muscles, and lacrimal gland. F, Enlarged view of the region of the cavernous sinus. The PCA and SCA have been exposed coursing above and below the oculomotor and trochlear nerves, respectively. The optic nerve is exposed above the internal carotid artery. An opening has been made into the lateral wall of the sphenoid sinus between the first and second divisions. The maxillary nerve passes forward to join the terminal branches of the maxillary artery in the pterygopalatine fossa. The maxillary nerve continues forward along the floor of the orbit as the infraorbital nerve. The superior ophthalmic vein descends across the origin of the lateral rectus muscle and enters the anterior portion of the cavernous sinus. (Images courtesy of AL Rhoton, Jr.)

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