title: Endoscopic endonasal approach to the ethmoidal planum: anatomic study.
abstract: The endoscopic endonasal technique is currently used by otolaryngologists for the management of different extradural lesions located below the ethmoidal planum. The cooperation between ENTs and neurosurgeons has recently pushed the use of such approach also in the removal of some intradural lesions, which has promoted the interest for an anatomic study to identify the anatomical landmarks and the dangerous points during the endoscopic approach to this area. In six fresh cadaver heads, unilateral and bilateral measurements between the main landmarks of the approach were performed by means of an endoscopic endonasal approach. A wide exposure of the midline anterior skull base was realized. The maximum of lateral extension was obtained between the two medial orbital walls, at the middle of the cribriform plate (mean distance 25,33 mm), while the mean distance between the anterior and posterior ethmoidal arteries at the level of the lamina papyracea was 16 mm. The endoscopic endonasal route can be considered a minimally invasive technique to approach the ethmoidal planum. It requires adequate anatomical knowledge and endoscopic skill for its realization. Due to the wide window realizable through this corridor, it could be considered in selected cases for the removal of intradural lesions such as meningiomas or estesioneuroblastomas.
authors.affiliation: Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: de Notaris
authors.forename: Isabella
authors.initials: I
authors.lastname: Esposito
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Cavallo
authors.forename: Anna Carrera
authors.initials: AC
authors.lastname: Burgaya
authors.forename: Alberto Prats
authors.initials: AP
authors.lastname: Galino
authors.forename: Felice
authors.initials: F
authors.lastname: Esposito
authors.forename: José M
authors.initials: JM
authors.lastname: Poblete
authors.forename: Enrique
authors.initials: E
authors.lastname: Ferrer
authors.forename: Paolo
authors.initials: P
authors.lastname: Cappabianca
mesh_terms: D002102:Cadaver; D002536:Cerebral Arteries / Q000033:anatomy & histology / Q000601:surgery; D004388:Dura Mater / Q000601:surgery; D004724:Endoscopy; D005004:Ethmoid Bone / Q000033:anatomy & histology / Q000601:surgery*; D006801:Humans; D009296:Nasal Cavity / Q000033:anatomy & histology / Q000601:surgery*; D009300:Nasal Septum / Q000033:anatomy & histology / Q000601:surgery; D019635:Neurosurgical Procedures; D019291:Skull Base / Q000033:anatomy & histology / Q000601:surgery; D014420:Turbinates / Q000033:anatomy & histology / Q000601:surgery