title: Quantitative anatomic comparison of the extended pterional transtemporal transtentorial approach and the subtemporal transtentorial approach to the petroclival region.
abstract: OBJECTIVE
  The anatomic characters and applicability of the extended pterional transtemporal transtentorial (EPTT) approach versus the subtemporal transtentorial (ST) approach for surgical treatment of petroclival tumors were evaluated.
  
  
  METHODS
  Ten sides from five adult Chinese injected cadavers were manipulated using both two approaches. Four deep bony anatomic landmarks were specified in the skull base to create two adjoining triangles that were respectively located in the anterior and posterior petroclival region. The real, projected area and the percentage of the projected area were determined and calculated to compare the deep exposure from the two approaches.
  
  
  RESULTS
  There was no difference regarding the percentage of the projected area was calculated in the anterior triangles (EPTT, 21.5±12.5%; ST, 28.8±14.9%; p=0.1948), but a significant difference was present in the posterior triangles (EPTT, 74.0±4.5%; ST, 51.5±4.3%; p < 0.01). Compared with the ST approach, the EPTT approach provides an equivalent percentage of projected area in the middle cranial fossa and a wider exposed area in the posterior cranial fossa.
  
  
  CONCLUSIONS
  Through anatomic comparative analysis the EPTT approach provides better exposure and is more appropriate than the ST approach for large and giant petroclival tumors predominantly in the posterior cranial fossa with extensive invasion to parasellar structures and the cavernous sinus.
authors: Nanjing University, School of Medicine, Jinling Hospital, Department of Neurosurgery, Nanjing, China.
authors: Yong
authors: Y
authors: Tang
authors: Han-Dong
authors: HD
authors: Wang
authors: Chi-Yuan
authors: CY
authors: Ma
authors: Chao-Shuang
authors: CS
authors: Zhan
authors: Xiang-Jun
authors: XJ
authors: Ji
authors: Lin
authors: L
authors: Zhu
authors: Wei
authors: W
authors: Li
authors: Wan-Chun
authors: WC
authors: You
authors: Hai-Ping
authors: HP
authors: Lin
authors: Wu-Zhao
authors: WZ
authors: Zhong
mesh_terms: D000328:Adult; D059925:Anatomic Landmarks; D002102:Cadaver; D003388:Cranial Fossa, Posterior / Q000033:anatomy & histology* / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D006801:Humans; D010579:Petrous Bone / Q000033:anatomy & histology* / Q000601:surgery; D013702:Temporal Lobe / Q000033:anatomy & histology / Q000601:surgery