Anatomical study in human cadaver of the endoscopic approaches to the pterygopalatine fossa and anterior skull base

• Grant number: 05/04424-3
• Support Opportunities: Regular Research Grants
• Start date: March 01, 2006
• End date: September 30, 2007
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Luiz Ubirajara Sennes
• Grantee: Luiz Ubirajara Sennes
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Functional endoscopic sinus represents a great advance in the approach to the deep spaces of the face and skull base diseases. Nowadays, through this approach it is possible to treat many congenital defects (such as meningoencephaloceles), traumatic lesions (such as cranial nerve compressions and CSF fistulas), and tumors (such as juvenile nasopharyngeal angiofibroma, clivus chordomas, hypophysis adenoma), among others. However, this region has a extremely complex anatomy and has not been well studied using this approach. Thus, as the endoscopic transnasal approach represents a great advance, it is essential to the surgeon to domain this anatomy in order to avoid complications and sequels. The anatomical knowledge of this region is possible only through cadaveric dissection which is very restricted, even in terciary universitary centers. So, it is extremely important the development of didactic material to make possible the study and anatomical teaching of this region, in order to garantee the adequate preparation of surgeons in this specialty. Objective. Transnasal endoscopic anatomical study of the pterygopalatine fossa and skull base, developing a method of teaching and trainning for endoscopic surgery of this region. Methods. Seven cadavers head in formaldehyde prepared with the injection of colouring material in intracranial arteries and veins will be dissected. The pterygopalatine fossa and skull base will be approached, exposing the vascular and neural adjacent structures. Based on these topographic relations, it will be systematizated a dissection guideline to approach this region safely and preservating functionally important structures. The limits of surgical exposure and the manouvers to increase it will be studied. The whole procedure and anatomical landmarks will be documented in digital cameras and camdcorders to further use and preparation of didactic material... (AU)