title: Midsubtemporal ridge as a predictor of the lateral loop formed by the maxillary nerve and mandibular nerve: a cadaveric morphological study.
abstract: BACKGROUND
  The lateral loop formed by the maxillary nerve (V2) and the mandibular nerve (V3) consists of a part of the far lateral triangle of the cavernous sinus. Because this triangle becomes a surgical corridor of the preauricular infratemporal fossa approach and a landmark of the extradural approach for the ganglion-type trigeminal schwannomas, identification of the lateral loop has important implications at the early stage of middle cranial base surgery. We realized that a bony ridge usually existed just lateral to the lateral loop.
  
  
  OBJECTIVE
  To nominate midsubtemporal ridge (MSR) as the name for this anatomically unnamed bony ridge and to clarify its features.
  
  
  METHODS
  Using 35 cadaver heads, we measured the shape of the MSR on both sides and the distance between the MSR and the adjacent structures.
  
  
  RESULTS
  The MSR was recognized in 60 of 70 specimens (85.7%). The bony protrusion was 2.9 ± 1.1 mm in height, 6.0 ± 2.1 mm in width, and 9.1 ± 3.2 mm in length. A single peak with anteroposterior length was common in 47 of 60 specimens (78.3%). The MSR was located at the midpoint of the V2 and V3 in 28 specimens (46.7%) and existed 10.7 ± 3.6 mm lateral from the line that bound the foramen rotundum and the foramen ovale.
  
  
  CONCLUSIONS
  We demonstrate morphological characteristics of the MSR. These data on the MSR will assist the surgeon in identifying the lateral loop as a surgical landmark during middle cranial base surgery.
authors.affiliation: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan. wanibuti@sapmed.ac.jp
authors.forename: Masahiko
authors.initials: M
authors.lastname: Wanibuchi
authors.forename: Gen
authors.initials: G
authors.lastname: Murakami
authors.forename: Taro
authors.initials: T
authors.lastname: Yamashita
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Minamida
authors.forename: Takanori
authors.initials: T
authors.lastname: Fukushima
authors.forename: Allan H
authors.initials: AH
authors.lastname: Friedman
authors.forename: Mineko
authors.initials: M
authors.lastname: Fujimiya
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Houkin
mesh_terms: D002102:Cadaver; D002426:Cavernous Sinus / Q000033:anatomy & histology*; D006801:Humans; D008340:Mandibular Nerve / Q000033:anatomy & histology*; D008442:Maxillary Nerve / Q000033:anatomy & histology*