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JOURNAL OF NEUROSURGICAL SCIENCES

A Journal on Neurosurgery


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Journal of Neurosurgical Sciences 2018 Jan 26

DOI: 10.23736/S0390-5616.18.04330-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Limits of endoscopic endonasal transpterygoid approach to cavernous sinus and Meckel’s cave

Douglas A. HARDESTY 1, 2, Alaa S. MONTASER 1, 3, Ricardo L. CARRAU 1, 4, Daniel M. PREVEDELLO 1, 4

1 Department of Neurological Surgery, Wexner Medical Center, The Ohio State University College of Medicine, Columbus, OH, USA; 2 Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA; 3 Department of Neurosurgery, Ain Shams University, Cairo, Egypt; 4 Department of Otolaryngology, Head and Neck Surgery, Wexner Medical Center, The Ohio State University College of Medicine, Columbus, OH, USA


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The endoscopic endonasal approach (EEA) to the ventral skull base has greatly increased in popularity over the last two decades. So-called expanded EEA have opened corridors to pathology off-midline, including lesions within the cavernous sinus and Meckel’s cave. A standard EEA exposure into the sphenoid sinus allows visualization of the medial cavernous sinus; a transpterygoid approach allows for surgical manipulation of the lateral cavernous sinus and Meckel’s cave contents. Pituitary adenomas, meningiomas, and schwannomas are the most common pathologies in this region. This approach to the “front door” of the cavernous sinus and Meckel’s cave should be considered complementary to traditional craniotomy techniques as each have benefits and limitations. Herein we review the published literature regarding endoscopic endonasal transpterygoid surgery for pathology in the lateral cavernous sinus and Meckel’s cave, and the anatomical and functional limitations of these approaches.


KEY WORDS: Skull base/surgery - Neurosurgical procedures/methods - Endoscopy/methods

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Publication History

Article first published online: January 26, 2018
Manuscript accepted: January 11, 2018
Manuscript received: January 7, 2018

Cite this article as

Hardesty DA, Montaser AS, Carrau RL, Prevedello DM. Limits of endoscopic endonasal transpterygoid approach to cavernous sinus and Meckel’s cave. J Neurosurg Sci 2018 Jan 26. DOI: 10.23736/S0390-5616.18.04330-8

Corresponding author e-mail

daniel.prevedello@osumc.edu