• Karol Zaczkowski, Bartosz Szmyd, Nicol Zielińska, Ernest Jan Bobeff, Issael Ramirez, Krzysztof Tybor, Łukasz Olewnik, Dariusz Jan Jaskólski, and Karol Wiśniewski.
• Department of Neurosurgery and Neurooncology, Medical University of Lodz, Barlicki University Hospital, Lodz, Poland. Electronic address: zaku2210@gmail.com.
• World Neurosurg. 2024 Sep 1; 189: e287e293e287-e293.

BackgroundAnterior petrosectomy (AP) is a commonly recognized approach for accessing tumors located in the petrous apex region. The essence of AP lies in drilling the petrous part of the temporal bone within the Kawase quadrangle. In our study, we conducted radiological and anatomical analyses of the structures within the petrous portion of the temporal bone, evaluating their impact on the surgical field during AP.MethodsWe conducted an analysis of 15 anatomical specimens and 20 3D reconstructions based on computed tomography scans of the middle ear. The analyzed structures included the impression of the trigeminal nerve, the groove of the greater petrosal nerve, the arcuate eminence, and the angle between eminentia arcuata and grove for greater petrosal nerve.ResultsThe mean surface area measured by radiological methods does not deviate significantly from the mean surface area measured by anatomical methods 276.265mm2 (interquartile range: 217.603-309.188) versus 233.21mm2 (interquartile range: 210.923-255.453) P = 0.051. We established a threshold 195,99mm2 for radiological determination of the surface area at which another approach should be considered. Additionally, we have developed corrections for specific radiological factors to enable a better assessment of anatomical conditions.ConclusionsOur results indicate that preoperative assessment of anatomical conditions based on 3D reconstructions of computed tomography of the middle ear can be a valuable tool in preoperative planning of surgery on tumors in the petroclival region using the AP. Further studies involving a larger sample size are necessary to validate the findings of our study.Copyright © 2024 Elsevier Inc. All rights reserved.

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