title: Endoscopic approach to the trigeminal nerve: an anatomic study.
abstract: OBJECTIVE
  To describe an endoscopic perspective of the surgical anatomy of the trigeminal nerve.
  
  
  METHODS
  Nine adult cadaveric heads were dissected endoscopically.
  
  
  RESULTS
  Opening the pterygopalatine fossa is important because many key anatomical structures (V2, pterygopalatine ganglion, vidian nerve) can be identified and traced to other areas of the trigeminal nerve. From the pterygopalatine ganglion, the maxillary nerve and vidian nerve can be identified, and they can be traced to the gasserian ganglion and internal carotid artery. An anteromedial maxillectomy increases the angle of approach from the contralateral nares due to an increase in diameter of the piriform aperture, and provides excellent access to the mandibular nerve, the petrous carotid, and the cochlea.
  
  
  CONCLUSIONS
  Identification of key anatomical structures in the pterygopalatine fossa can be used to identify other areas of the trigeminal nerve, and an anteromedial maxillectomy is necessary to expose the ipsilateral mandibular nerve and contralateral cranial level of the trigeminal nerve.
authors.affiliation: Department of Neurosurgery, Yuquan Hospital, Tsinghua University, 5 Shijingshan Road, Shijingshan District, Beijing 100049, China.
authors.forename: Jia-ping
authors.initials: JP
authors.lastname: Zheng
authors.affiliation: Department of Neurosurgery, Sanbo Brain Hospital Affiliated with Capital Medical University, Beijing 100093, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Song
authors.affiliation: Department of Neurosurgery, Sanbo Brain Hospital Affiliated with Capital Medical University, Beijing 100093, China.
authors.forename: Xiang-xin
authors.initials: XX
authors.lastname: Zhan
authors.affiliation: Beijing Neurosurgical Institute, 6 Tiantan Xili, Beijing 100050, China.
authors.forename: Chu-zhong
authors.initials: CZ
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, 6 Tiantan Xili, Beijing 100050, China.
authors.forename: Xu-yi
authors.initials: XY
authors.lastname: Zong
authors.affiliation: Beijing Neurosurgical Institute, 6 Tiantan Xili, Beijing 100050, China. Electronic address: zyz2004520@163.com.
authors.forename: Ya-zhuo
authors.initials: YZ
authors.lastname: Zhang
mesh_terms: D000328:Adult; D002102:Cadaver; D002343:Carotid Artery, Internal / Q000033:anatomy & histology; D003051:Cochlea / Q000098:blood supply / Q000294:innervation; D019723:Endoscopes; D006801:Humans; D008340:Mandibular Nerve / Q000033:anatomy & histology; D008437:Maxilla / Q000294:innervation / Q000601:surgery; D008442:Maxillary Nerve / Q000033:anatomy & histology; D009296:Nasal Cavity / Q000294:innervation; D057605:Natural Orifice Endoscopic Surgery / Q000295:instrumentation / Q000379:methods*; D009882:Ophthalmic Nerve / Q000033:anatomy & histology; D010579:Petrous Bone / Q000098:blood supply; D010781:Photography / Q000295:instrumentation; D056739:Pterygopalatine Fossa / Q000294:innervation; D013101:Sphenoid Sinus / Q000098:blood supply / Q000294:innervation; D013701:Temporal Bone / Q000294:innervation; D012668:Trigeminal Ganglion / Q000033:anatomy & histology; D014276:Trigeminal Nerve / Q000033:anatomy & histology* / Q000601:surgery
keywords: Endoscopic; Maxillotomy; Petroclival region; Pterygopalatine fossa; Trigeminal